Individual provider Active NPI

Angela Nicolle Wilson, CRNA

  • Certified Registered Nurse Anesthetist
  • Webster, TX
National Provider Identifier
1699867440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
643442 Issued in TX
Practice address
500 Medical Center Blvd
Webster, TX 77598-4220
Phone
(281) 218-9515
NPI assigned
Sep 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 643442 TX Primary

Addresses

Primary practice location

500 Medical Center Blvd
Webster, TX 77598-4220

Mailing address

3206 Revere St Apt 215
Houston, TX 77098-2236
Phone (713) 301-1105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050902000672 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810929411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texans Anesthesia Associates PLLCGroup PAC ID 8820171390, 197 clinicians

Practice addresses (Care Compare)

1635 N Loop W
Houston, TX 77008-1532
Phone (713) 400-2990

7401 Main St
Houston, TX 77030-4509
Phone (713) 400-2990

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
643442TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texans Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 15, 2014 Accepting new patients

Locations

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

7401 Main St
Houston, TX 77030
Phone (713) 799-8600

7700 Fannin St
Houston, TX 77054
Phone (713) 790-1349

9525 Katy Fwy
Ste 206
Houston, TX 77024
Phone (713) 400-2993

21720 Kingsland Blvd
Ste 101
Katy, TX 77450
Phone (281) 492-1234

5146 Preston Ave
Pasadena, TX 77505
Phone (345) 203-5600

Organizations & group practices 1

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699867440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 REVERE ST APT 215",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770982236",
            "telephone_number": "713-301-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984220",
            "telephone_number": "281-218-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ANGELA",
        "middle_name": "NICOLLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "643442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.