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NPI Code Detail

MEDICARE: ANDREW O SPENCER CRNA

MEDICARE:   ANDREW O SPENCER  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 Anesthetist710567TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760617039
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW O SPENCER CRNA
Provider Business Mailing Address
First Line : PO BOX 678431
Second Line :
City : DALLAS
State : TX
Zip : 75267-8431
Country : US
Telephone Number : 979-245-2677
Fax Number :
Provider Business Practice Location Address
First Line : 720 AVENUE F N
Second Line :
City : BAY CITY
State : TX
Zip : 77414-9573
Country : US
Telephone Number : 979-245-2777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2009
Last Update Date : 04/27/2010

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Directions to “ ANDREW O SPENCER CRNA” Practice Location

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