Individual
BRIAN ROBERT WALFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1501 E MOCKINGBIRD LN, SUITE 220, VICTORIA, TX 77904-2155
(361) 573-6291
(361) 576-2434
Mailing address
PO BOX 4897, HOUSTON, TX 77210-4897
(903) 787-5850
(903) 787-5854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
736013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171759701
—
TX
01
—
84981U
BLUE CROSS
TX
Enumeration date
08/03/2006
Last updated
08/16/2022
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