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Individual

GREGORY P RENDELMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1600 11TH ST, WICHITA FALLS, TX 76301-4300
(940) 764-7000
Mailing address
4217 CANYON TRAILS DR, WICHITA FALLS, TX 76309-2705
(940) 692-7085

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
705261
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
169907601
TX
01
84703U
BCBSTX
TX
Enumeration date
07/31/2006
Last updated
10/29/2007
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