Provider Demographics
NPI:1356507347
Name:SIMBURGER, EARL MARK (CRNA)
Entity Type:Individual
Prefix:MR
First Name:EARL
Middle Name:MARK
Last Name:SIMBURGER
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 1:2900 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3106
Mailing Address - Country:US
Mailing Address - Phone:713-512-6000
Mailing Address - Fax:713-512-6021
Practice Address - Street 1:2900 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3106
Practice Address - Country:US
Practice Address - Phone:713-512-6000
Practice Address - Fax:713-512-6021
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX029236367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0028110-01OtherTEXAS PROVIDER IDENTIFIER