| David Stephen Prudhome, CRNA | |
|
1000 S Beckham Ave, Tyler, TX 75701-1908 | |
| (903) 597-0351 | |
| Not Available |
| Full Name | David Stephen Prudhome |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 13 Years |
| Location | 1000 S Beckham Ave, Tyler, 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 |
|---|---|---|---|
| 1437494879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 733431 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus Health Shreveport - Bossier | Shreveport, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Christus Health Northern Louisiana | 8628980554 | 23 |
| Entity Name | Willis Knighton Medical Center Inc Crna Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174546097 PECOS PAC ID: 1759358674 Enrollment ID: O20040910001124 |
| Entity Name | Medical Center Anesthesiologists |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669469748 PECOS PAC ID: 6608814843 Enrollment ID: O20050419001114 |
| Entity Name | Christus Health Northern Louisiana |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801822762 PECOS PAC ID: 8628980554 Enrollment ID: O20060111000997 |
| Mailing Address | Practice Location Address |
|---|---|
| David Stephen Prudhome, CRNA 1000 S Beckham Ave, Tyler, TX 75701-1908 Ph: (903) 597-0351 | David Stephen Prudhome, CRNA 1000 S Beckham Ave, Tyler, TX 75701-1908 Ph: (903) 597-0351 |
Mrs. Glenda R Sealey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1424 East Front, Tyler, TX 75702 Phone: 903-595-4144 Fax: 903-596-7541 | |
John Glynn Jeansonne, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1000 S Beckham Ave, Tyler, TX 75701 Phone: 903-526-1068 Fax: 903-593-4290 | |
Jeffrey Manglicmot, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-531-4522 | |
Harold Richie Bandalan, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 S Beckham Ave, Tyler, TX 75701 Phone: 903-526-1068 Fax: 903-593-4290 | |
Jeffrey David Barker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 S Beckham Ave, Tyler, TX 75701 Phone: 903-597-0351 | |
Gregory Mallett, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-606-4522 | |
Cara L Dewolfe, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-593-8441 |