BERT DOUGLAS LARSON

AUSTIN, TX
NPI1811229305
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  AP129840)
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  890134)
Enumeration Date2010-02-08
Last Update Date2020-06-18
Business Address
Mr. BERT DOUGLAS LARSON CRNA
3705 MEDICAL PKWY SUITE 570
AUSTIN, TX 78705-1019
Phone number: 512-454-2554
Mailing Address
Mr. BERT DOUGLAS LARSON CRNA
PO BOX 840853
DALLAS, TX 75284-0853
Phone number: 972-233-1999