Organization · NPI-2
Dogwood Anesthesia Management, LLC
Nurse Anesthetist, Certified Registered · Addison, TX
NPI number1619328135
StatusActive
Last updated in NPPESJun 27, 2016
Details
- NPI
- 1619328135
- Entity type
- Organization (NPI-2)
- Legal business name
- Dogwood Anesthesia Management, LLC
- Organization subpart
- No
- Enumeration date
- Jun 27, 2016
- Last updated
- Jun 27, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
| 261QP3300X | Clinic/Center, Pain | – | – |
Practice location
17051 Dallas Pkwy Ste 100Addison, TX 75001-7102
Phone 469-916-0521 · Fax 972-234-0212
Mailing address
Po Box 674422Dallas, TX 75267-4422
Phone 469-916-0521 · Fax 972-234-0212
Authorized official
Tracy Walls
President
9722344740
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