Individual
MR. MICHAEL E AULT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
605 HOLDERRIETH BLVD, TOMBALL, TX 77375-6445
(281) 880-8190
Mailing address
15610 KELLAN CT, CYPRESS, TX 77429-6115
(281) 246-4462
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
558297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048795
RECERTIFICATION AANA
TX
05
—
83140H7
—
TX
01
—
85386U
BCBS
TX
Enumeration date
09/26/2005
Last updated
07/08/2007
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