MEDICARE: BELLA AMOR 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	367500000X	Certified Registered Nurse Anesthetist	723733	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	043537	OTHER	TX	043537
2	723733	OTHER	TX	REGISTERED NURSE LICENSE

General Provider Information

NPI Number	:	1346268273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELLA AMOR CRNA

Provider Business Mailing Address
First Line	:	2305 DELTA BRIDGE DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-1566
Country	:	US
Telephone Number	:	713-436-7202
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 GRAMERCY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1617
Country	:	US
Telephone Number	:	713-436-7202
Fax Number	:

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	01/10/2008

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Directions to “ BELLA AMOR CRNA” Practice Location

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