Individual ProviderSamuel Richard HeathNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705(512) 454-2554(972) 233-1999PECOS EnrollmentBased on the most recent information from CMS, provider Samuel Richard Heath does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1023407517Provider TypeIndividualFull NameHeath, Samuel RichardCredentialCRNAGenderMaleSole ProprietorNoEnumeration Date1/21/2015Last Updated6/16/2020Contact InformationPractice LocationPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705Phone(512) 454-2554FaxUnlisted FaxMailing LocationMailing AddressPO Box 840853, Dallas, TX 75284-0853Phone(972) 233-1999Fax(972) 233-3666Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP127222TexasCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense779067Texas