Provider Demographics
NPI:1285677716
Name:SHULTZ, DAVID ALLEN (CRNA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:SHULTZ
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 1:3115 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9752
Mailing Address - Country:US
Mailing Address - Phone:956-383-6806
Mailing Address - Fax:
Practice Address - Street 1:3115 SUNSET DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9752
Practice Address - Country:US
Practice Address - Phone:956-383-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX027127367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered