Waller, Charles F.

Waller, Charles F. is an individual health care provider with primary practice located at 321 N Bailey Ave , Fort Worth TX 76107-1001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Waller, Charles F. can be contacted via phone (817) 378-8573.

Contact Information

Primary practice address
321 N Bailey Ave Fort Worth TX 76107-1001
Phone: (817) 378-8573
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 564644 Texas

Profile Details

NPI number 1760455265
LBN Legal business name Waller, Charles F.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760455265 NPPES
Texas Other 83479U BLUE CROSS

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