Organization · NPI-2
12th Street Anesthesia PLLC
Nurse Anesthetist, Certified Registered · Wolfforth, TX
NPI number1497604029
StatusActive
Last updated in NPPESJan 26, 2026
Details
- NPI
- 1497604029
- Entity type
- Organization (NPI-2)
- Legal business name
- 12th Street Anesthesia PLLC
- Organization subpart
- No
- Enumeration date
- Jan 26, 2026
- Certification date
- Jan 26, 2026
- Last updated
- Jan 26, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
Practice location
12108 Fm 179Wolfforth, TX 79382-7034
Phone 940-445-2398
Mailing address
12108 Fm 179Wolfforth, TX 79382-7034
Phone 940-445-2398
Authorized official
Todd Hobbs
Managing Member
9404452398
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