Provider Demographics
NPI:1053719542
Name:WALKER ANESTHESIA SERVICES, PLLC
Entity type:Organization
Organization Name:WALKER ANESTHESIA SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:432-488-6909
Mailing Address - Street 1:1513 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-2630
Mailing Address - Country:US
Mailing Address - Phone:432-488-6909
Mailing Address - Fax:432-520-2723
Practice Address - Street 1:4519 N GARFIELD ST
Practice Address - Street 2:SUITE 15
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-3415
Practice Address - Country:US
Practice Address - Phone:432-520-0291
Practice Address - Fax:432-520-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL30256367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty