Individual provider Active NPI

Raul Sandoval Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
National Provider Identifier
1205224508
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP127178 Issued in TX
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(915) 504-0540
NPI assigned
Jan 8, 2015
Last updated
Feb 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP127178 TX Primary

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

1500 S Main St
Fort Worth, TX 76104-4917
Phone (915) 504-0540

Other practice location 1

2930 N Stanton St
El Paso, TX 79902-2511
Phone (915) 271-4569

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150211001633 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840515987 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Ams, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2020 Accepting new patients
El Paso Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Feb 10, 2020 Accepting new patients
Noble Anesthesia Partners, PLLC CurrentSince Mar 18, 2021 Accepting new patients
BHS Physicians Network, Inc CurrentSince Feb 10, 2020 Accepting new patients
El Paso County Hospital District Past Accepting new patients

Locations

9101 N Central Expy
Ste 550
Dallas, TX 75231
Phone (214) 442-0055

125 W Castellano Dr
El Paso, TX 79912
Phone (915) 532-8200

1300 Murchison Dr
Ste 180
El Paso, TX 79902
Phone (915) 544-5000

1620 N Mesa St
El Paso, TX 79902
Phone (210) 660-5040

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

2000 Transmountain Rd
El Paso, TX 79911
Phone (915) 247-8893

2930 N Stanton St
El Paso, TX 79902
Phone (915) 271-4569

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

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.

NPI Registry JSON

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1205224508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "915-504-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "915-504-0540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2930 N Stanton St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799022511",
            "country_code": "US",
            "telephone_number": "915-271-4569",
            "fax_number": "915-351-0086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "RAUL",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-08",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP127178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; 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.