1467037937 NPI number — TEXAS ANESTHESIA TEAM PLLC

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 1467037937 NPI number — TEXAS ANESTHESIA TEAM PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS ANESTHESIA TEAM 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:
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:
1467037937
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
182 INDUSTRIAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN ROCK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17327-8626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-759-4375
Provider Business Mailing Address Fax Number:
717-759-4336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8706 FREDERICKSBURG RD STE 104
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:
78240-1293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-764-6819
Provider Business Practice Location Address Fax Number:
210-598-7918
Provider Enumeration Date:
03/16/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REECE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
832-331-2969

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)