Provider Demographics
NPI:1922064310
Name:MYERS, PAUL ROBERT (CRNA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ROBERT
Last Name:MYERS
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:PO BOX 4346
Mailing Address - Street 2:DEPT 675
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:281-358-8114
Mailing Address - Fax:281-358-0609
Practice Address - Street 1:2606 GRANT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2836
Practice Address - Country:US
Practice Address - Phone:713-227-4600
Practice Address - Fax:713-227-4202
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652399367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86172UOtherBLUE CROSS/BLUE SHIELD
TX070305OtherAANA
TX166691901Medicaid