Mr Martin E Rivera, CRNA | |
2626 S Jackson, Jacksonville, TX 75766 | |
(903) 541-4630 | |
(903) 586-5710 |
Full Name | Mr Martin E Rivera |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 2626 S Jackson, Jacksonville, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184694416 | NPI | - | NPPES |
917426801 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 073074 (Missouri) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 1139215 (Texas) | Primary |
Entity Name | Us Anesthesia Partners Of Florida Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518910520 PECOS PAC ID: 0345143152 Enrollment ID: O20040129000594 |
Mailing Address | Practice Location Address |
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Mr Martin E Rivera, CRNA Po Box 220, Rolla, MO 65402-0220 Ph: (573) 458-8899 | Mr Martin E Rivera, CRNA 2626 S Jackson, Jacksonville, TX 75766 Ph: (903) 541-4630 |
Mr. Barry Lynn Thibodeaux, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1463 Se Loop 456, Jacksonville, TX 75766 Phone: 903-589-1150 | |
David Newsom, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 501 S Ragsdale St, Jacksonville, TX 75766 Phone: 903-677-1000 Fax: 903-677-1694 | |
Timothy B Different, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2026 S Jackson St, Jacksonville, TX 75766 Phone: 903-586-5678 Fax: 903-541-4679 | |
Mr. Jack David Capps, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2026 S Jackson St, Jacksonville, TX 75766 Phone: 903-541-4500 |