Provider Demographics
NPI:1992899405
Name:BIENERT, ROBERT W (CRNA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:BIENERT
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:PO BOX 650865
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0865
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:1500 CITYWEST BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-2300
Practice Address - Country:US
Practice Address - Phone:713-620-4000
Practice Address - Fax:713-458-4229
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN88371367500000X
TXAP120178367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8340UEOtherBCBS
TX8667UMOtherBCBS
TXP01304452OtherRAIL ROAD
TX280840405Medicaid
TX280840406Medicaid
TXTIN PLUS 015OtherTRICARE
LA1156892Medicaid
TX75-1976930-005OtherTRICARE
TX8314UBOtherBCBS BILLING NUMBER
TXP01745932OtherRR MEDICARE
TX280840408Medicaid
TX280840405Medicaid
TX295389YSE3Medicare PIN
TXP01304452OtherRAIL ROAD
TX8667UMOtherBCBS
TX280840406Medicaid