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Individual
ROBERT SCOTT BOURGEOIS
Active
Individual
ROBERT SCOTT BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
652839
TX
367500000X
Certified Registered Nurse Anesthetist
NA3113
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1858615 01
—
TX
05
—
2112333
—
LA
01
—
86991U
BLUE CROSS PROVIDER ID
TX
01
—
P00396099
RAILROAD MEDICARE
TX
Enumeration date
12/08/2006
Last updated
07/22/2010
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