Individual
MICHAEL E BAEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4519 N GARFIELD ST, SUITE 15, MIDLAND, TX 79705-3415
(432) 699-0952
Mailing address
PO BOX 4157, 4519 N. GARFIELD STE 15, MIDLAND, TX 79704-4157
(432) 699-0225
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
708712
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP119817
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219995204
—
TX
01
—
219995205
MEDICAID CSHCN
TX
01
—
8919UC
BCBS
TX
01
—
P01072435
RAILROAD
TX
Enumeration date
01/11/2011
Last updated
02/21/2023
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