Basic Information
| Provider Information | |||||||||
| NPI: | 1902965494 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAYES | ||||||||
| FirstName: | BUD | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 252 W 86TH ST | ||||||||
| Address2: | |||||||||
| City: | CUT OFF | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703453475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856328545 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 W 134TH PL | ||||||||
| Address2: | |||||||||
| City: | CUT OFF | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703454143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9856326401 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN065712 AP01550 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | ST243 | 01 | LA | TAX NUMBER | OTHER | 1984621 | 05 | LA | MEDICAID |