Individual ProviderDavid Len RenneckerNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019(512) 454-2454PECOS EnrollmentBased on the most recent information from CMS, provider David Len Rennecker 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 ID1043293442Provider TypeIndividualFull NameRennecker, David LenCredentialCRNAGenderMaleSole ProprietorNoEnumeration Date11/21/2005Last Updated11/1/2007Contact InformationPractice LocationPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Mailing LocationMailing Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense40367TexasProvider IdentifiersIDDescriptionIssuerID80237CDescriptionOtherIssuerBC/BSTexasID88549301DescriptionMedicaidIssuerUnlistedTexas