Provider Demographics
NPI:1336169366
Name:MCEWAN, JAMES MAX (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MAX
Last Name:MCEWAN
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 1:614 PECAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9631
Mailing Address - Country:US
Mailing Address - Phone:972-226-1091
Mailing Address - Fax:972-226-2911
Practice Address - Street 1:614 PECAN CREEK DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9631
Practice Address - Country:US
Practice Address - Phone:972-226-1091
Practice Address - Fax:972-226-2911
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33099367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSD-72OtherBLUE CROSS-BLUE SHIELD
TXSD-72OtherBLUE CROSS-BLUE SHIELD