MEDICARE: NORTH TEXAS ANESTHETISTS, LLC

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	70862	TX

General Provider Information

NPI Number	:	1346785854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TEXAS ANESTHETISTS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 272682
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77277-2682
Country	:	US
Telephone Number	:	713-487-8910
Fax Number	:	713-583-4325

Provider Business Practice Location Address
First Line	:	2452 LAKEWOOD DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75054-6800
Country	:	US
Telephone Number	:	972-743-2126
Fax Number	:	214-988-2082

Authorized Official
Title or Position	:	OWNER/ PROVIDER
Name	:	MR. ROBERT M HOWINGTON
Credential	:	CRNA
Telephone Number	:	972-743-2126

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	12/20/2016

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