Individual provider Active NPI

Edgar Milam, CRNA

  • Certified Registered Nurse Anesthetist
  • Temple, TX
National Provider Identifier
1154359545
Registry record updated Sep 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
65047 Issued in TX
Practice address
1901 SW H K Dodgen Loop
Temple, TX 76502-1814
Phone
(254) 935-4000
Fax
(254) 935-4111
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 65047 TX Primary
Certified Registered Nurse Anesthetist 367500000X RN65047 TN

Addresses

Primary practice location

1901 SW H K Dodgen Loop
Temple, TX 76502-1814

Mailing address

P.O. Box 844658
Dallas, TN 75284-4658

Other identifiers 1

IdentifierTypeStateIssuer
4134284OtherTNBC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170817003056 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133116254 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Cowboy Anesthesia Services PLLCGroup PAC ID 4385868512, 6 clinicians

Practice addresses (Care Compare)

1100 E Loop Rd
Crockett Med Ctr
Crockett, TX 75835-1308
Phone (936) 545-3851

303 Sandy Corner Rd
El Campo, TX 77437-9535
Phone (979) 643-6251

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
65047TXMDClinical Social Worker
RN65047TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Grasshopper Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2020 Accepting new patients
Cowboy Anesthesia Services PLLC CurrentSince Jul 1, 2023 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
Medical Anesthesia Group, PA PastSince Feb 24, 1997 Accepting new patients
Ridge Lake Anesthesia Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3201 University Dr E
Ste 420
Bryan, TX 77802
Phone (979) 485-9922

3811 Sagebriar Dr
Bryan, TX 77802
Phone (979) 774-0498

1100 E Loop 304
Crockett, TX 75835
Phone (936) 546-3862

303 Sandy Corner Rd
El Campo, TX 77437
Phone (979) 543-6251

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

1305 Wonder World Dr
Ste 105
San Marcos, TX 78666
Phone (512) 353-8161

10141 US 59 Hwy
Wharton, TX 77488
Phone (281) 491-6808

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1154359545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 844658",
            "city": "DALLAS",
            "state": "TN",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SW H K DODGEN LOOP",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765021814",
            "telephone_number": "254-935-4000",
            "fax_number": "254-935-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAM",
        "first_name": "EDGAR",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "65047",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN65047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "4134284",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.