MEDICARE: STEVEN L BELVEDERE 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	238721	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	97030	OTHER	AR	BLUE CROSS
4	84290C	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1598763096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN L BELVEDERE CRNA

Provider Business Mailing Address
First Line	:	1129 VERONA WAY
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-2977
Country	:	US
Telephone Number	:	817-431-8935
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 TUSCAN DR
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-4133
Country	:	US
Telephone Number	:	214-442-1905
Fax Number	:

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	02/23/2016

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