MEDICARE: JAMES CARTER 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	554002	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8931UC	OTHER	TX	TX BCBS
2	04-3628717	OTHER	TX	CLAY CARTER CRNA, PC
3	104461	OTHER	TX	SUPERIOR
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	532365185	OTHER	TX	TAX ID BLUEBONNET ANESTH.
8	BCBS	OTHER	TX	84738U

General Provider Information

NPI Number	:	1710942719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES CARTER CRNA

Provider Business Mailing Address
First Line	:	1081 RIVER TER
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3417
Country	:	US
Telephone Number	:	830-627-8988
Fax Number	:

Provider Business Practice Location Address
First Line	:	1081 RIVER TER
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3417
Country	:	US
Telephone Number	:	830-627-8988
Fax Number	:

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	10/30/2013

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