Individual
JOHN EARL HEARLD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-9374
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
662169
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D06437
MCR GRP. RR
—
01
—
P00977272
MEDICARE RAILROAD PROVIDER NUMBER
TX
Enumeration date
11/20/2007
Last updated
09/28/2015
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