Individual provider Active NPI

David Brent Aguillard, CRNA

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1811073513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
657733 Issued in TX
Practice address
13601 Preston Rd
Dallas, TX 75240-4911
Phone
(972) 715-5007
Fax
(972) 715-5682
NPI assigned
Oct 27, 2006
Sex
Male
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 657733 TX Primary

Addresses

Primary practice location

13601 Preston Rd
Dallas, TX 75240-4911

Mailing address

13601 Preston Rd
Dallas, TX 75240-4911
Phone (972) 715-5007

Other identifiers 2

IdentifierTypeStateIssuer
657733OtherTXTSBNE
RN087475OtherLARN087475

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080114000755 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668574773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willis Knighton Medical Center Inc Crna GroupGroup PAC ID 1759358674, 93 clinicians

Practice addresses (Care Compare)

2600 Greenwood Rd
Shreveport, LA 71103-3908
Phone (318) 212-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesiologists CurrentSince Feb 1, 2016 Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered CurrentSince Aug 21, 2017 Accepting new patients
Med-Trans Corporation Past Accepting new patients

Locations

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1500 Line Ave
Shreveport, LA 71101
Phone (318) 213-3754

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

Organizations & group practices 3

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

Hospital & facility affiliations 4

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811073513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404911",
            "telephone_number": "972-715-5007",
            "fax_number": "972-715-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404911",
            "telephone_number": "972-715-5007",
            "fax_number": "972-715-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILLARD",
        "first_name": "DAVID",
        "middle_name": "BRENT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "657733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSBNE",
            "identifier": "657733",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN087475",
            "identifier": "RN087475",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, 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.