Provider Demographics
NPI:1518203991
Name:FUSILIER, PAUL SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:SCOTT
Last Name:FUSILIER
Suffix:
Gender:M
Credentials:CRNA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 122431
Mailing Address - Street 2:DEPT 2431
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2431
Mailing Address - Country:US
Mailing Address - Phone:337-480-8900
Mailing Address - Fax:337-480-8901
Practice Address - Street 1:755 N 11TH ST
Practice Address - Street 2:SUITE P3600
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1500
Practice Address - Country:US
Practice Address - Phone:409-838-5214
Practice Address - Fax:409-838-1946
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2018-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP124625367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered