Provider Demographics
NPI:1497074843
Name:VASQUEZ-AMAYA, KARLA W (CRNA)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:W
Last Name:VASQUEZ-AMAYA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:W
Other - Last Name:ALBINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:520 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4414
Mailing Address - Country:US
Mailing Address - Phone:210-581-2823
Mailing Address - Fax:210-581-2836
Practice Address - Street 1:520 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4414
Practice Address - Country:US
Practice Address - Phone:210-581-2823
Practice Address - Fax:210-581-2836
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLANT9206034367500000X
TXAP141285367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01084031OtherRAILROAD MEDICARE
FL0025762 00Medicaid
FLXXX-XX-9687OtherCHAMPUS TRICARE - SOUTH REGION
FLG00FUOtherBCBS
FL0025762 00Medicaid