Organization · NPI-2

Birch Anesthesia Management, LLC

Nurse Anesthetist, Certified Registered · Addison, TX

NPI number1033568134
StatusActive
Last updated in NPPESJun 9, 2016

Details

NPI
1033568134
Entity type
Organization (NPI-2)
Legal business name
Birch Anesthesia Management, LLC
Organization subpart
No
Enumeration date
Jun 9, 2016
Last updated
Jun 9, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered––Yes
261QP3300X Clinic/Center, Pain––

Practice location

17051 Dallas Pkwy Ste 100
Addison, TX 75001-7102

Phone 469-916-0521 · Fax 972-234-0212

Mailing address

Po Box 674429
Dallas, TX 75267-4429

Phone 469-916-0521 · Fax 972-234-0212

Authorized official

Tracy Walls
President
9722344740

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