Organization · NPI-2

Booneville Anesthesia Services LLC

Anesthesiology · Richardson, TX

NPI number1104092089
StatusActive
Last updated in NPPESMay 1, 2008

Details

NPI
1104092089
Entity type
Organization (NPI-2)
Legal business name
Booneville Anesthesia Services LLC
Organization subpart
No
Enumeration date
May 1, 2008
Last updated
May 1, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207L00000X Anesthesiology––Yes

Practice location

1200 E Collins Blvd
Suite 110
Richardson, TX 75081-2457

Phone 866-913-8528 · Fax 214-239-1660

Mailing address

1200 E Collins Blvd
Suite 110
Richardson, TX 75081-2457

Phone 866-913-8528 · Fax 214-239-1660

Authorized official

Brandon Johnson
President/Ceo
8669138528

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