Individual
ALEX PENTECOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(855) 600-5163
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60717743
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
129045
TX
367500000X
Certified Registered Nurse Anesthetist
AP60782203
WA
Other
Enumeration date
08/17/2017
Last updated
12/06/2023
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