Provider Demographics
NPI:1487682217
Name:ROUSE, ALAN (CRNA)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ROUSE
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 1:146 E HOSPITAL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4169
Mailing Address - Country:US
Mailing Address - Phone:979-848-3068
Mailing Address - Fax:979-849-1423
Practice Address - Street 1:146 E HOSPITAL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4169
Practice Address - Country:US
Practice Address - Phone:979-848-3068
Practice Address - Fax:979-849-1423
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224168163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX430042026OtherUNSPECIFIED RAILROAD MEDICARE
TX120029704Medicaid
TX120029704Medicaid
TXR95368Medicare UPIN