Organization
DREAMWISE ANESTHESIA ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN JOHNSON CRNA (MANAGER)
(936) 639-3036
Entity
Organization
Contact information
Practice address
1201 W FRANK AVE, LUFKIN, TX 75904-3357
(936) 639-3036
Mailing address
PO BOX 1447, LUFKIN, TX 75902-1447
(936) 639-3036
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C84P
BCBS
TX
05
—
155375201
—
TX
Enumeration date
06/04/2006
Last updated
07/29/2009
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