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NPI Code Detail

MEDICARE: MR. DAVID F SIMON CRNA

MEDICARE: MR. DAVID F SIMON CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist236123TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
182566UOTHERTXBCBSTX

General Provider Information

NPI Number : 1174501837
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID F SIMON CRNA
Provider Business Mailing Address
First Line : 15117 AQUARIUS ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78418-6904
Country : US
Telephone Number : 361-949-1059
Fax Number :
Provider Business Practice Location Address
First Line : 2606 HOSPITAL BLVD
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78405-1818
Country : US
Telephone Number : 361-902-4275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 10/26/2007

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