Larry Wayne Shock Jr, CRNA | |
13737 Noel Road, Suite 1400, Dallas, TX 75240-2004 | |
(972) 715-5000 | |
(972) 715-9976 |
Full Name | Larry Wayne Shock Jr |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 13 Years |
Location | 13737 Noel Road, Dallas, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265717904 | NPI | - | NPPES |
P01102917 | Other | TX | RAILROAD MEDICARE PTAN |
200458930A | Medicaid | OK | |
8476UD | Other | TX | BCBS PIN |
306652401 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 786298 (Texas) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 786298 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Integris Southwest Medical Center | Oklahoma city, OK | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Anesthesia Medical Professionals Pllc | 5991970279 | 90 |
Entity Name | Anesthesia Medical Professionals Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962785931 PECOS PAC ID: 5991970279 Enrollment ID: O20111215000187 |
Mailing Address | Practice Location Address |
---|---|
Larry Wayne Shock Jr, CRNA Po Box 650865, Dallas, TX 75265-0865 Ph: (972) 715-5000 | Larry Wayne Shock Jr, CRNA 13737 Noel Road, Suite 1400, Dallas, TX 75240-2004 Ph: (972) 715-5000 |
Mrs. Charity Cabrera Magcalas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 12222 Merit Dr Ste 600, Dallas, TX 75251 Phone: 972-715-5000 Fax: 972-715-9976 | |
Jennie A Potts, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 13601 Preston Rd, 1000w, Dallas, TX 75240 Phone: 972-715-5000 | |
Eric Lara, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5200 Harry Hines Blvd, Dallas, TX 75235 Phone: 469-419-2850 | |
Ms. Justina Osagioduwa Nwokedi, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6606 Lbj Fwy Ste 200, Dallas, TX 75240 Phone: 972-715-5000 Fax: 972-715-9976 | |
Lauren Carter Segerson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 12222 Merit Dr Ste 600, Dallas, TX 75251 Phone: 972-715-5000 Fax: 972-715-9976 | |
Hannah Neipp Murdock, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 12222 Merit Dr Ste 600, Dallas, TX 75251 Phone: 972-715-5000 Fax: 972-715-9976 | |
Jeannie K Murphy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6606 Lbj Fwy, Suite 200, Dallas, TX 75240 Phone: 972-715-5000 Fax: 972-715-9976 |