Provider Demographics
NPI:1679507750
Name:PITCHER, ROBERT F (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:PITCHER
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 1:3109 LAZY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7434
Mailing Address - Country:US
Mailing Address - Phone:315-717-6557
Mailing Address - Fax:
Practice Address - Street 1:1702 N ED CAREY DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8202
Practice Address - Country:US
Practice Address - Phone:956-423-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX549686367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165156401Medicaid
KY7100008860Medicaid
TX8B8817Medicare ID - Type Unspecified
TX165156401Medicaid