MEDICARE: ROME ANESTHESIA PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist		TX

General Provider Information

NPI Number	:	1073051397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROME ANESTHESIA PLLC

Provider Business Mailing Address
First Line	:	7557 RAMBLER RD STE 730
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2405
Country	:	US
Telephone Number	:	214-452-7705
Fax Number	:

Provider Business Practice Location Address
First Line	:	7557 RAMBLER RD STE 730
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2405
Country	:	US
Telephone Number	:	214-452-7705
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. SEAN JONES-QUAIDOO
Credential	:	MD
Telephone Number	:	214-452-7705

Provider Enumeration Date	:	02/07/2017
Last Update Date	:	02/07/2017

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