Provider Demographics
NPI:1831176049
Name:GARNER, EDGAR LEE (CRNA)
Entity type:Individual
Prefix:MR
First Name:EDGAR
Middle Name:LEE
Last Name:GARNER
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 1:7100 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1704
Mailing Address - Country:US
Mailing Address - Phone:806-355-9595
Mailing Address - Fax:
Practice Address - Street 1:800 QUAIL CREEK DR STE 103
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1634
Practice Address - Country:US
Practice Address - Phone:806-358-7911
Practice Address - Fax:806-358-9600
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231154367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089022004Medicaid
TX85096UOtherBLUE CROSS & BLUE SHIELD
R57077Medicare UPIN
TX8D3744Medicare PIN