Organization · NPI-2

Havencrest Anesthesia PLLC

Nurse Anesthetist, Certified Registered · Addison, TX

NPI number1295340719
StatusActive
Last updated in NPPESSep 11, 2020

Details

NPI
1295340719
Entity type
Organization (NPI-2)
Legal business name
Havencrest Anesthesia PLLC
Organization subpart
No
Enumeration date
Sep 11, 2020
Certification date
Sep 11, 2020
Last updated
Sep 11, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered––Yes

Practice location

16633 Dallas Pkwy Ste 150
Addison, TX 75001-6812

Phone 214-390-7697 · Fax 888-770-6360

Mailing address

960 Ridgeview Drive Ste 140 Pmb 192
Allen, TX 75013

Phone 214-390-7697 · Fax 888-770-6360

Authorized official

Johnny W East
Admin
2143907697

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