Watson, Larry G

Watson, Larry G is an individual health care provider with primary practice located at 4100 Summerhill Rd , Texarkana TX 75503-2732. 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. Watson, Larry G can be contacted via phone (903) 735-9802.

Contact Information

Primary practice address
4100 Summerhill Rd Texarkana TX 75503-2732
Phone: (903) 735-9802
Fax: (903) 735-9806
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1065502 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 229614 Texas

Profile Details

NPI number 1467450619
LBN Legal business name Watson, Larry G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Sep 6th, 2023 - about 2 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 1467450619 NPPES
Arkansas Other 1467450619 ARKANSAS BLUE CROSS
Arkansas MEDICAID 088825703 ARKANSAS BLUE CROSS
Arkansas MEDICAID 120883701 ARKANSAS BLUE CROSS
Arkansas Other 8089UH ARKANSAS BLUE CROSS

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