Provider Demographics
NPI:1164411740
Name:SCHIESSLER, DAVID MARK (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:SCHIESSLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1827
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-1827
Mailing Address - Country:US
Mailing Address - Phone:325-641-2655
Mailing Address - Fax:325-641-0992
Practice Address - Street 1:5602 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-1227
Practice Address - Country:US
Practice Address - Phone:325-793-3755
Practice Address - Fax:325-793-3750
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX569775367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX596775OtherLICENSE #
TXP0022932OtherRR MEDICARE INDIV. #
TX85907UOtherBCBS INDIVIDUAL #
TX00C86SOtherBCBS GROUP #
TX87629UOtherBCBSTX
TXDD3524OtherRR MEDICARE GOUP #
TX00C86SOtherBCBS GROUP #
TX8F1843Medicare ID - Type UnspecifiedINDIVIDUAL #
TX87629UOtherBCBSTX