Individual
VIDELS BOBBY MECHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-7632
(608) 263-8100
(608) 262-6247
Mailing address
PO BOX 840853, DALLAS, TX 75284-4917
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1027310
TX
367500000X
Certified Registered Nurse Anesthetist
1027310
TX
367500000X
Certified Registered Nurse Anesthetist
317196
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
802492
WI
Other
Enumeration date
01/15/2021
Last updated
10/07/2025
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