Individual
MICHAEL BLAINE NESMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
619214
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
619214
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165515106
—
TX
01
—
8973UG
BCBS
TX
01
—
P01446623
RR
TX
Enumeration date
12/30/2005
Last updated
10/20/2023
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