Individual
MR. BRIAN ROBERT ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
3201 W HIGHWAY 22, CORSICANA, TX 75110-2450
(903) 654-6800
(903) 654-6989
Mailing address
2241 F. M. 984, ENNIS, TX 75119-0955
(972) 646-5278
(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
—
1627689-02
—
TX
Enumeration date
06/10/2005
Last updated
03/06/2009
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