Mr Marvin T Colyer, CRNA | |
1333 S Sam Houston Blvd, Houston, MO 65483-2046 | |
(417) 967-1265 | |
(417) 967-1328 |
Full Name | Mr Marvin T Colyer |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1333 S Sam Houston Blvd, Houston, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437104304 | NPI | - | NPPES |
1437104304 | Medicaid | MO | |
26D0446923 | Other | MO | CLIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 043360 (Missouri) | Primary |
Entity Name | Texas County Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790740363 PECOS PAC ID: 9436041696 Enrollment ID: O20041220000543 |
Mailing Address | Practice Location Address |
---|---|
Mr Marvin T Colyer, CRNA 1333 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-1265 | Mr Marvin T Colyer, CRNA 1333 S Sam Houston Blvd, Houston, MO 65483-2046 Ph: (417) 967-1265 |
Mr. Larry Wayne Ladd, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1333 S Sam Houston Blvd, Texas Co Memorial Hospital, Houston, MO 65483 Phone: 417-967-3311 | |
Mr. James S Spantgos, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1333 S Sam Houston Blvd, Houston, MO 65483 Phone: 417-967-3311 Fax: 417-967-3764 |