Organization · NPI-2
Addison Headache Associates, LLC
Nurse Anesthetist, Certified Registered · Addison, TX
NPI number1407276793
StatusActive
Last updated in NPPESJun 6, 2016
Details
- NPI
- 1407276793
- Entity type
- Organization (NPI-2)
- Legal business name
- Addison Headache Associates, LLC
- Organization subpart
- No
- Enumeration date
- Apr 24, 2014
- Last updated
- Jun 6, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – |
Practice location
17051 Dallas PkwySte 100
Addison, TX 75001-7101
Phone 469-916-0521 · Fax 972-231-7095
Mailing address
Po Box 674183Dallas, TX 75267-4183
Phone 972-479-1115 · Fax 972-346-8015
Authorized official
Tracy Walls
Manager
9722344740
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