MEDICARE: SYMMETRY ANESTHESIA CLINICIANS 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
2	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1164353975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYMMETRY ANESTHESIA CLINICIANS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 739505
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-9505
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 8TH AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4110
Country	:	US
Telephone Number	:	817-922-1535
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PHILIP EICHENHOLZ
Credential	:	MD
Telephone Number	:	214-727-6596

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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