Organization
B. R. A. ANESTHESIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN ROBERT ANDERSEN BSN, CRNA (PRESIDENT)
(214) 399-0034
Entity
Organization
Contact information
Practice address
2241 F. M. 984, ENNIS, TX 75119-0955
(214) 399-0034
(972) 646-5278
Mailing address
2241 F. M. 984, ENNIS, TX 75119-0955
(214) 399-0034
(972) 646-5278
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
705290
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1762759-02
—
TX
01
—
888174
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/03/2006
Last updated
05/05/2010
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