| Mary G Hartzog, RN, CRNA | |
|
2401 S 31st St, Temple, TX 76508-0001 | |
| (254) 724-2111 | |
| Not Available |
| Full Name | Mary G Hartzog |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 2401 S 31st St, Temple, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598929036 | NPI | - | NPPES |
| 89461U | Other | TX | BCBSTX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 697733 (Texas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP116926 (Texas) | Primary |
| Entity Name | Austin Anesthesiology Group Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598724304 PECOS PAC ID: 0547256497 Enrollment ID: O20040424000086 |
| Entity Name | Endo Sedation Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588931174 PECOS PAC ID: 4789845363 Enrollment ID: O20120406000221 |
| Entity Name | Austin Gastroenterology Anesthesia Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427405810 PECOS PAC ID: 6305138603 Enrollment ID: O20160707000274 |
| Entity Name | Anesthesia Dynamics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073001012 PECOS PAC ID: 3779832530 Enrollment ID: O20200422002521 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary G Hartzog, RN, CRNA 4100 Duval Rd, Bldg 3, Austin, TX 78759-4275 Ph: (254) 724-8800 | Mary G Hartzog, RN, CRNA 2401 S 31st St, Temple, TX 76508-0001 Ph: (254) 724-2111 |
Mr. Nicholas Grant Smith, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2401 S 31st St, Temple, TX 76504 Phone: 254-724-2111 | |
Justin Robert Anders, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 | |
Joshua Joseph Philippon, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 Fax: 254-724-7603 | |
Clarence E. Grunden, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1905 Sw H K Dodgen Loop, Temple, TX 76502 Phone: 254-298-2682 Fax: 254-778-7197 | |
Maelen Bernasor, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 | |
Violeta Maier Hutson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 | |
Christe Mossman, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2401 S 31st St, Temple, TX 76508 Phone: 254-724-2111 |