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Organization
VICTORIA ANESTHESIOLOGY ASSOC LLP
Active
Organization
VICTORIA ANESTHESIOLOGY ASSOC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BUDDY R NIELSEN MD (MD)
(361) 573-2481
Entity
Organization
Contact information
Practice address
1501 E MOCKINGBIRD LN, SUITE 101, VICTORIA, TX 77904-2155
(361) 573-6291
(361) 576-2434
Mailing address
PO BOX 4897, HOUSTON, TX 77210-4897
(361) 573-6291
(361) 576-2434
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N42X
BLUE CROSS GRP MD
TX
05
—
00N42X
—
TX
05
—
0841793-02
—
TX
01
—
C31N
BCBS TX CRNAS
TX
01
—
CD3812
RR MEDICARE
TX
Enumeration date
08/20/2006
Last updated
08/18/2016
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