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Individual

JASPER MICHAEL NEUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
700 WALTER REED BLVD, STE.302, GARLAND, TX 75042-3701
(972) 276-6100
Mailing address
7303 ROBIN RD, DALLAS, TX 75209-3921
(817) 988-8845

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
239486
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144394703
TX
05
144394705
TX
01
87651U
BCBS
TX
01
8L9574
TX MEDICARE
TX
Enumeration date
07/03/2006
Last updated
04/11/2017
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