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Individual

ISAGANI L. SACULO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4315 28TH ST SUITE 2, SUITE 1C282, LUBBOCK, TX 79410-2507
(806) 792-2104
Mailing address
1503 LANCELOT AVENUE, WOLFFORTH, TX 79382-3200
(903) 452-3558
(806) 745-2337

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP114739
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149984100
FIRSTCARE COMMERCIAL
TX
05
149984101
TX
05
182510101
TX
05
200082440A
OK
01
202005978
PRESBYTERIAN COMMERCIAL
NM
05
202005978
NM
01
70408009
CONSULTEC
NM
01
86408U
HMO BLUE
TX
01
86409U
BC/BS
TX
Enumeration date
06/18/2006
Last updated
01/11/2023
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