| Mr Michael E Ault, CRNA | |
|
605 Holderrieth Blvd, Tomball, TX 77375-6445 | |
| (281) 880-8190 | |
| Not Available |
| Full Name | Mr Michael E Ault |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 605 Holderrieth Blvd, Tomball, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154317196 | NPI | - | NPPES |
| 048795 | Other | TX | RECERTIFICATION AANA |
| 83140H7 | Medicaid | TX | |
| 85386U | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 558297 (Texas) | Primary |
| Entity Name | Northwest Anesthesiology & Pain Services, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629027511 PECOS PAC ID: 9638067408 Enrollment ID: O20040304001244 |
| Entity Name | Sequoia Anesthesia Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215611983 PECOS PAC ID: 0840653101 Enrollment ID: O20240712003555 |
| Entity Name | Evergreen Anesthesia Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275377277 PECOS PAC ID: 5395282487 Enrollment ID: O20240807001686 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael E Ault, CRNA 15610 Kellan Ct, Cypress, TX 77429-6115 Ph: (281) 246-4462 | Mr Michael E Ault, CRNA 605 Holderrieth Blvd, Tomball, TX 77375-6445 Ph: (281) 880-8190 |
Trisha Brown Stroderd, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 605 Holderrieth Blvd, Tomball, TX 77375 Phone: 281-401-7006 |