Provider Demographics
NPI:1689288524
Name:PMR CRNA, PLLC
Entity Type:Organization
Organization Name:PMR CRNA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNA, NSPM-C
Authorized Official - Phone:817-966-2762
Mailing Address - Street 1:960 RIDGEVIEW DR STE 140-196
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5542
Mailing Address - Country:US
Mailing Address - Phone:817-966-2762
Mailing Address - Fax:
Practice Address - Street 1:220 O CONNOR RIDGE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6573
Practice Address - Country:US
Practice Address - Phone:214-390-7697
Practice Address - Fax:888-770-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty