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NPI Code Detail

MEDICARE: MR. WILLIAM B EZELL CRNA

MEDICARE: MR. WILLIAM B EZELL 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 Anesthetist051342TX
2367500000XCertified Registered Nurse AnesthetistAP110320TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
485650UOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1710975941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM B EZELL CRNA
Provider Business Mailing Address
First Line : PO BOX 840853
Second Line :
City : DALLAS
State : TX
Zip : 75284-0865
Country : US
Telephone Number : 972-715-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1500 CITYWEST BLVD STE 300
Second Line :
City : HOUSTON
State : TX
Zip : 77042-2549
Country : US
Telephone Number : 713-620-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 04/28/2020

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Directions to “ MR. WILLIAM B EZELL CRNA” Practice Location

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