MEDICARE: PAUL ROBERT MYERS 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	652399	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86172U	OTHER	TX	BLUE CROSS/BLUE SHIELD
2	070305	OTHER	TX	AANA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922064310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL ROBERT MYERS CRNA

Provider Business Mailing Address
First Line	:	PO BOX 4346
Second Line	:	DEPT 675
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	281-358-8114
Fax Number	:	281-358-0609

Provider Business Practice Location Address
First Line	:	2606 GRANT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-2836
Country	:	US
Telephone Number	:	713-227-4600
Fax Number	:	713-227-4202

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	06/28/2011

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