NPIMap

Organization Active NPI

Brazos Gi Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Waco, TX
National Provider Identifier
1073806360
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
BRAZOS GI ANESTHESIA LLC
Practice address
364 Richland West Cir
Suite B
Waco, TX 76712-7919
Phone
(254) 537-0306
NPI assigned
May 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Edward Contreras, M.D.
Title
President
Phone
(254) 537-0306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

364 Richland West Cir
Suite B
Waco, TX 76712-7919

Mailing address

364 Richland West Cir
Waco, TX 76712-7919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110830000318 TX Part B Supplier - Clinic/Group Practice 7113197161 Receives reassigned benefits from 17 practitioners
Practice locations: Waco, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1073806360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 RICHLAND WEST CIR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 RICHLAND WEST CIR",
            "address_2": "SUITE B",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127919",
            "telephone_number": "254-537-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS GI ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2023-09-07",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-537-0306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.