Organization · NPI-2
Addison Anesthesia Management LLC
Nurse Anesthetist, Certified Registered · Addison, TX
NPI number1962874727
StatusActive
Last updated in NPPESJun 6, 2016
Details
- NPI
- 1962874727
- Entity type
- Organization (NPI-2)
- Legal business name
- Addison Anesthesia Management LLC
- Organization subpart
- No
- Enumeration date
- Oct 20, 2015
- Last updated
- Jun 6, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
| 261QP3300X | Clinic/Center, Pain | – | – |
Practice location
17051 Dallas PkwySuite 100
Addison, TX 75001-7109
Phone 972-215-7410
Mailing address
Po Box 674006Dallas, TX 75267-4006
Phone 972-479-1115 · Fax 972-479-1118
Authorized official
Kristy Mcgill
Dir Of Network Development
9722157410
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