| Mr Gregory Scott Wallis, CRNA | |
|
1204 N Mound St, Nacogdoches, TX 75961-4027 | |
| (936) 568-8444 | |
| Not Available |
| Full Name | Mr Gregory Scott Wallis |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 22 Years |
| Location | 1204 N Mound St, Nacogdoches, 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 |
|---|---|---|---|
| 1376698290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 630401 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Texas Anesthesia Partners | 4183802176 | 2 |
| Entity Name | Texas Anesthesia Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184656001 PECOS PAC ID: 4183802176 Enrollment ID: O20110621000786 |
| Entity Name | Youngs Professional Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922178599 PECOS PAC ID: 2163524992 Enrollment ID: O20120104000614 |
| Entity Name | Texas Anesthesia Partners, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144673468 PECOS PAC ID: 3870879828 Enrollment ID: O20170406000406 |
| Entity Name | Grasshopper Anesthesia Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932635752 PECOS PAC ID: 3072882315 Enrollment ID: O20170630000438 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Gregory Scott Wallis, CRNA 106 County Road 253, Nacogdoches, TX 75965-6980 Ph: (936) 554-7297 | Mr Gregory Scott Wallis, CRNA 1204 N Mound St, Nacogdoches, TX 75961-4027 Ph: (936) 568-8444 |
Ms. Nancy Joanne Batzloff, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 919 County Road 2131, Nacogdoches, TX 75965 Phone: 936-560-1338 | |
Wallace D Womack, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1204 N Mound St, Nacogdoches, TX 75961 Phone: 936-568-8525 | |
Mr. Ronald Anthony Freeland, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1204 N Mound St, Nacogdoches, TX 75961 Phone: 936-564-4611 | |
Mr. Jerry L Mixon, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 4920 Ne Stallings Dr, Nacogdoches, TX 75965 Phone: 936-569-9481 Fax: 936-462-4333 | |
Mrs. Kendra Brooks Stockman, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3610 N University Dr, Nacogdoches, TX 75965 Phone: 936-254-4703 | |
Mr. James H. Newberg, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1204 N Mound St, Nacogdoches, TX 75961 Phone: 936-568-8444 |