Provider Demographics
NPI:1629014220
Name:EPSTEIN, RICHARD ALLEN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALLEN
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:ALLEN
Other - Last Name:EPSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:13561 DUCAT CT
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6912
Mailing Address - Country:US
Mailing Address - Phone:512-468-8475
Mailing Address - Fax:361-949-0852
Practice Address - Street 1:13561 DUCAT CT
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6912
Practice Address - Country:US
Practice Address - Phone:512-468-8475
Practice Address - Fax:361-949-0852
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX690093367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L10615OtherTX MEDICARE
TX86145UOtherBLUE CROSS & BLUE SHIELD
TX8L10615OtherTX MEDICARE
TX8J7441Medicare PIN
TX86145UOtherBLUE CROSS & BLUE SHIELD