| Adam Nicholas Myers, | |
|
403 Willowbend Dr, Port Lavaca, TX 77979-2262 | |
| (817) 879-3996 | |
| Not Available |
| Full Name | Adam Nicholas Myers |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 403 Willowbend Dr, Port Lavaca, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003522525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP61405206 (Washington) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP1188082 (Texas) | Primary |
| Entity Name | Providence Wa Anesthesia Services, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669615894 PECOS PAC ID: 9335298884 Enrollment ID: O20090513000135 |
| Mailing Address | Practice Location Address |
|---|---|
| Adam Nicholas Myers, 403 Willowbend Dr, Port Lavaca, TX 77979-2262 Ph: (817) 879-3996 | Adam Nicholas Myers, 403 Willowbend Dr, Port Lavaca, TX 77979-2262 Ph: (817) 879-3996 |
Robert D Coleman, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 815 N Virginia St, Port Lavaca, TX 77979 Phone: 361-573-6291 Fax: 361-576-2434 | |
Mr. Gregory Wade Cowart, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 815 N Virginia St, Port Lavaca, TX 77979 Phone: 361-552-6713 Fax: 361-552-0338 | |
Mr. Mark Neal Gorman, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1818 Broadway St, Port Lavaca, TX 77979 Phone: 361-552-3505 |