MEDICARE: MR. ARNOLD VICTOR WORLEY 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	163W00000X	Registered Nurse	767221	TX
2	367500000X	Certified Registered Nurse Anesthetist	RN 067122	LA
3	367500000X	Certified Registered Nurse Anesthetist	AP 02726	LA
4	367500000X	Certified Registered Nurse Anesthetist	046058 AANA	TX
5	367500000X	Certified Registered Nurse Anesthetist	AP118017	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	57602	OTHER	CLINICAL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750457362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARNOLD VICTOR WORLEY CRNA

Provider Business Mailing Address
First Line	:	12222 N CENTRAL EXPY
Second Line	:	SUITE 400
City	:	DALLAS
State	:	TX
Zip	:	75243-3755
Country	:	US
Telephone Number	:	469-218-0678
Fax Number	:	469-587-6684

Provider Business Practice Location Address
First Line	:	12222 N CENTRAL EXPY
Second Line	:	SUITE 400
City	:	DALLAS
State	:	TX
Zip	:	75243-3755
Country	:	US
Telephone Number	:	469-218-0678
Fax Number	:	469-587-6684

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

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	12/30/2024

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Directions to “ MR. ARNOLD VICTOR WORLEY CRNA” Practice Location

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