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NPI 1083848352
● Active Type 2 · Organization
Subpart
East Texas Medical Center Henderson
Nurse Anesthetist, Certified Registered · Henderson, TX · NPI 1083848352
·
Enumerated 2009 · 17 years on NPI
East Texas Medical Center Henderson is 1 of 6676 nurse anesthetist, certified registered organizations in Texas.
NPI age
17 years
Enumerated 2009-05-14
Primary specialty
Nurse Anesthetist, Certified Registered
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Leitner
Administrator
Last NPPES update
2011-07-19
Source: monthly bulk 2026-05
How this organization compares
Across 6676 active nurse anesthetist, certified registered providers in Texas.
NPI age
17 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
NPI lifetime · 2009 → 2026
2009-05 Enumerated in NPPES
2009
2026
Where they practice
Primary practice location
300 Wilson St
Henderson, TX 756525956
📞 9036577541 fax 9036574009
Mailing address
300 Wilson St
Henderson, TX 756525956
📞 9036577541 fax 9036574009
Authorized official
Mark S Leitner
Administrator
📞 9036553616
Individual providers at this organization
16 individual providers on file at this primary practice address.
Jathan Cantu , M.D.
Family Medicine
NPI 1932174596
Joseph Carver , D.O.
Family Medicine
NPI 1720408909
Glena Davis , D.O.
Obstetrics & Gynecology
NPI 1932383981
Nino Fuller , AGACNP-BC
Nurse Practitioner
NPI 1962974469
Mark Hackbarth , MD
Anesthesiology
NPI 1629071527
Dwight Hall , CRNA
Nurse Anesthetist, Certified Registered
NPI 1770582736
Mica Norman , PMHNP-BC, FNP-C
Nurse Practitioner
NPI 1053953794
Cheryl Polkowski , M.D.
Family Medicine
NPI 1194882241
Adam Ranginwala , MD
Emergency Medicine
NPI 1114422623
Bruno Romeo Miramon , MD
Obstetrics & Gynecology
NPI 1366564148
Shawna Sharp , NP
Nurse Practitioner
NPI 1255954509
Nicole Stanley , NP
Nurse Practitioner
NPI 1730732942
Amanda Trubey , MSN, FNP-C
Nurse Practitioner
NPI 1205569761
Gordon Uretsky , MD
Family Medicine
NPI 1477512820
Angela Vera , RD, LD
Dietitian, Registered
NPI 1356626782
Jerry Wheeler , CRNA
Nurse Anesthetist, Certified Registered
NPI 1376672006
Specialties
Nurse Anesthetist, Certified Registered
Primary
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
taxonomy 367500000X
Identifiers
Type Value Notes
05 (TX)
220328301
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Practice context
Multi-provider organization.
16 individual providers on file at this primary address.
Subpart of East Texas Medical Center Henderson .
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How to verify this organization
Confirm the NPI on NPPES. The CMS registry is the system of record. Open NPPES →
Verify the organization is in good standing. Cross-check with the state's business registration and any applicable licensing boards.
Confirm payer enrollment if billing. NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.
Updated 2026-05-14
· Source: CMS NPPES bulk export. Praxis MD refreshes the directory monthly with weekly delta updates.
Independent public resource. Not affiliated with CMS, HHS, or NPPES. Not endorsed by the U.S. government.
NPI listing is not proof of active licensure or payer enrollment.