Provider Demographics
NPI:1467728634
Name:BRASHEARS, BILL HARRY (CRNA)
Entity Type:Individual
Prefix:MR
First Name:BILL
Middle Name:HARRY
Last Name:BRASHEARS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:HARRY
Other - Last Name:DEMETRIADES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1450 E LEAGUE CITY PKWY
Mailing Address - Street 2:APT. 727
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6054
Mailing Address - Country:US
Mailing Address - Phone:479-459-8632
Mailing Address - Fax:
Practice Address - Street 1:16516 EL CAMINO REAL
Practice Address - Street 2:#411
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-5723
Practice Address - Country:US
Practice Address - Phone:713-417-4216
Practice Address - Fax:281-488-8503
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARCO2900367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered