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Individual
TERI SPARKS ALEXANDER
Active
Individual
TERI SPARKS ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
681591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86181U
BCBS OF TEXAS
TN
01
—
P00308059
PART B RAILROAD MEDICARE
TX
Enumeration date
10/20/2006
Last updated
07/08/2007
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