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NPI Code Detail

MEDICARE: TEXOMA INFUSION AND VASCULAR ACCESS PLLC

MEDICARE: TEXOMA INFUSION AND VASCULAR ACCESS 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
1367500000XCertified Registered Nurse Anesthetist

General Provider Information

NPI Number : 1285111708
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXOMA INFUSION AND VASCULAR ACCESS PLLC
Provider Business Mailing Address
First Line : 3211 PRANCER WAY
Second Line :
City : CELINA
State : TX
Zip : 75009-1368
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5150 WARREN PKWY
Second Line :
City : FRISCO
State : TX
Zip : 75034-7462
Country : US
Telephone Number : 214-310-9023
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : FREDDIE LEE SIMPKINS II
Credential : CRNA
Telephone Number : 972-453-1879
Provider Enumeration Date : 07/26/2018
Last Update Date : 03/27/2019

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