Peter Holtz, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Eagle Pass, TX
NPI 1477552172 · NPPES record last updated Nov 30, 2022
Key facts
- NPI
- 1477552172
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- AP114181 (TX)
- Practice address
- 3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5893 - Phone
- (830) 773-5321
- NPI assigned
- Jul 15, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R32442 | NM | MD | Certified Registered Nurse Anesthetist |
| AP114181 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roswell Clinic Corp | Past | Accepting new patients | |
| Carlsbad Medical Center LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R32442 | NM | |
| Certified Registered Nurse Anesthetist | 367500000X | AP114181 | TX | Yes |
Addresses
Primary practice location
3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5893
Mailing address
3204 Rayburn St
Las Vegas, NM 87701-5124
Phone (573) 686-5550
Other practice location 1
1010 Spruce St
Espanola, NM 87532-3456
Phone (573) 686-5550 ext. 101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM006869 | Other | NM | INDIVIDUAL BCBS NM |
| 96583 | Medicaid | NM |
Other providers in Eagle Pass, TX
- Rosa Isela Herrera
- Hesles Provider Agency LLC
- Kristi Joy Hinton
- Brenda Guadalupe Hoffman
- Brooke E Holman
- Hometown Wellness Pharmacy, Inc
- Horizon Eagle Pass, LLC
- Rigoberto Hurtado
- In Our Hands Medical Transportation
- Inclusive Minds, PLLC
All providers in Eagle Pass, TX · Certified Registered Nurse Anesthetist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.