Individual
GARY L. HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
700 MEDICAL PKWY, BRENHAM, TX 77833
(979) 337-5000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
441803
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP100856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119980414
—
TX
01
—
8761UC
BCBS
TX
01
—
ARNP 2081562
STATE OF FLORIDA
FL
01
—
CO1544
ARKANSAS STATE BOARD OF NURSING
AR
Enumeration date
02/02/2006
Last updated
11/06/2020
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