Provider Demographics
NPI:1528041993
Name:NOVAK, MARCIA G (CRNA)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:G
Last Name:NOVAK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FM 1826
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-1407
Mailing Address - Country:US
Mailing Address - Phone:512-324-7000
Mailing Address - Fax:
Practice Address - Street 1:7900 FM 1826
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-1407
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28393367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152137901Medicaid
TX1528041993Medicaid
TX82435UOtherBC/BS
S49526Medicare UPIN
TX1528041993Medicaid