Provider Demographics
NPI:1124065651
Name:MING, EGBERT LOUIS (CRNA)
Entity type:Individual
Prefix:MR
First Name:EGBERT
Middle Name:LOUIS
Last Name:MING
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 1:3600 SAINT CHARLES AVE
Mailing Address - Street 2:SUITE100
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-7121
Mailing Address - Country:US
Mailing Address - Phone:504-899-0500
Mailing Address - Fax:504-899-0552
Practice Address - Street 1:5200B DAVIS LN STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4063
Practice Address - Country:US
Practice Address - Phone:512-834-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN042686 AP02297163W00000X
GARN217364367500000X
TXAP115816207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C371Medicare ID - Type UnspecifiedMEDICARE PROVIDER#