Organization
DEEP EAST TEXAS ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL S BREWTON CRNA (OWNER)
(936) 552-4760
Entity
Organization
Contact information
Practice address
4948 NE STALLINGS DR, NACOGDOCHES, TX 75965-1265
(936) 568-3595
Mailing address
638A N UNIVERSITY DR # 216, NACOGDOCHES, TX 75961-4617
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/18/2021
Last updated
08/10/2021
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