MEDICARE: JOSE NOE HERRERA 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
1	207L00000X	Anesthesiology Physician	616338	TX
2	367500000X	Certified Registered Nurse Anesthetist	616338	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295910156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE NOE HERRERA CRNA

Provider Business Mailing Address
First Line	:	5501 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9152
Country	:	US
Telephone Number	:	956-661-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	5415 S MCCOLL RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9183
Country	:	US
Telephone Number	:	956-661-0529
Fax Number	:	956-618-4639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	06/25/2019

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Directions to “ JOSE NOE HERRERA CRNA” Practice Location

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