1083162358 NPI number — STONEBRIAR ANESTHESIA ASSOCIATES, PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083162358 NPI number — STONEBRIAR ANESTHESIA ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STONEBRIAR ANESTHESIA ASSOCIATES, PA
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:
Provider Other Organization Name Type Code:
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:
1083162358
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 250368
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75025-0368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-390-7697
Provider Business Mailing Address Fax Number:
972-432-6692

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 MEDICAL PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77380-3241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-806-5758
Provider Business Practice Location Address Fax Number:
888-770-6360
Provider Enumeration Date:
09/15/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BAILEY
Authorized Official First Name:
THERESA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
972-954-1469

Provider Taxonomy Codes

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

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





Copyright © 2007-2025 www.npivalidator.com