1265458673 NPI number — ANESTHESIA ASSOCIATES OF SEGUIN PLLC

Table of content: (NPI 1699341131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265458673 NPI number — ANESTHESIA ASSOCIATES OF SEGUIN PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIA ASSOCIATES OF SEGUIN 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:
Provider Other Organization Name Type Code:
6
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:
1265458673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1215 E COURT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEGUIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78155-5129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-379-5867
Provider Business Mailing Address Fax Number:
830-401-4035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1215 E COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEGUIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78155-5129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-379-5867
Provider Business Practice Location Address Fax Number:
830-401-4035
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MAJOR
Authorized Official First Name:
DOLORES
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
M.D./MANAGING PARTNER
Authorized Official Telephone Number:
830-379-5867

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  G8264 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 081159801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00790N . This is a "BCBS GROUP" identifier . This identifiers is of the category "OTHER".




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