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Organization
SHERMAN GRAYSON HOSPITAL LLC
Active
Organization
SHERMAN GRAYSON HOSPITAL LLC
Active
Other names
D/B/A/ WNJ CRNA Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VANCE VERNON REYNOLDS (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(903) 870-4591
Entity
Organization
Contact information
Practice address
500 N HIGHLAND, SHERMAN, TX 75092
(903) 870-4611
(903) 891-2030
Mailing address
119 W HOUSTON ST, SHERMAN, TX 75090-5909
(903) 891-7000
(903) 813-1479
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C04E
BLUE CROSS BLUE SHIELD
TX
05
—
138349901
—
TX
01
—
CD4427
PALMETTO RAILROAD MEDICAR
TX
01
—
TXB133004
MEDICARE PTAN
TX
Enumeration date
06/15/2006
Last updated
02/24/2012
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