1184017741 NPI number — GCSA ANESTHESIA PLLC

Table of content: (NPI 1184017741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184017741 NPI number — GCSA ANESTHESIA PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GCSA ANESTHESIA PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALAMO CITY ENDOSCOPY ANESTHESIA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184017741
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MCS #226
Provider Second Line Business Mailing Address:
PO BOX 659831
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78265-9130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-1234
Provider Business Mailing Address Fax Number:
210-614-0954

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5223 HAMILTON WOLFE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-1234
Provider Business Practice Location Address Fax Number:
210-614-0954
Provider Enumeration Date:
03/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SHAFFER
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
210-614-1234

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com