Organization · NPI-2
Republic Anesthesia LLC
Nurse Anesthetist, Certified Registered · Bryan, TX
NPI number1215401831
StatusActive
Last updated in NPPESJan 16, 2019
Details
- NPI
- 1215401831
- Entity type
- Organization (NPI-2)
- Legal business name
- Republic Anesthesia LLC
- Organization subpart
- No
- Enumeration date
- Jan 16, 2019
- Last updated
- Jan 16, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
| 207T00000X | Neurological Surgery | – | – |
Practice location
3134 Briarcrest DrBryan, TX 77802-3014
Phone 979-777-8400
Mailing address
10592 County Road 175Iola, TX 77861-3617
Phone 979-777-8400
Authorized official
David Gaskin
President
9797778400
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