| Mr Jeffrey Fred Davang, CRNA | |
|
1501 E Mockingbird Ln, 101, Victoria, TX 77904-2155 | |
| (361) 573-2481 | |
| (361) 576-2434 |
| Full Name | Mr Jeffrey Fred Davang |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 24 Years |
| Location | 1501 E Mockingbird Ln, Victoria, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003806464 | NPI | - | NPPES |
| 83842U | Other | TX | BLUE CROSS/BLUE SHIELD |
| 052983 | Other | TX | RECERTIFICATION |
| 151044802 | Medicaid | TX | |
| P00090293 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 642422 (Texas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 642422 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| El Campo Memorial Hospital | El campo, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cowboy Anesthesia Services Pllc | 4385868512 | 4 |
| Entity Name | Victoria Anesthesiology Assoc Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881709780 PECOS PAC ID: 5395636716 Enrollment ID: O20040323001880 |
| Entity Name | Northstar Anesthesia Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912978610 PECOS PAC ID: 7315907128 Enrollment ID: O20041015000685 |
| Entity Name | Cowboy Anesthesia Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225459878 PECOS PAC ID: 4385868512 Enrollment ID: O20140610000631 |
| Entity Name | Citizens Medical Center County Of Victoria |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205242088 PECOS PAC ID: 3577785096 Enrollment ID: O20141117000499 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jeffrey Fred Davang, CRNA 3719 County Road 131, Wharton, TX 77488-8535 Ph: (713) 252-5200 | Mr Jeffrey Fred Davang, CRNA 1501 E Mockingbird Ln, 101, Victoria, TX 77904-2155 Ph: (361) 573-2481 |