Individual
MR. EDWARD COLLIER BOYTIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA, CNS
Contact information
Practice address
1737 BRIARCREST DR, SUITE 14, BRYAN, TX 77802-2769
(979) 776-4777
Mailing address
1737 BRIARCREST DR, SUITE 14, BRYAN, TX 77802-2769
(979) 776-4777
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
681543
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
681543
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181752-04
—
TX
Enumeration date
07/12/2007
Last updated
03/13/2017
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