MEDICARE: GUARDIAN ANESTHESIA SERVICES & PAIN

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	207L00000X	Anesthesiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447291885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN ANESTHESIA SERVICES & PAIN

Provider Business Mailing Address
First Line	:	4041 W WHEATLAND RD
Second Line	:	156 343
City	:	DALLAS
State	:	TX
Zip	:	75237-4064
Country	:	US
Telephone Number	:	972-223-7878
Fax Number	:	972-283-0284

Provider Business Practice Location Address
First Line	:	1010 E WHEATLAND RD
Second Line	:	SUITE A
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4914
Country	:	US
Telephone Number	:	972-283-0063
Fax Number	:	972-283-0284

Authorized Official
Title or Position	:	MD
Name	:	MRS. JAYASHREE N GORREPATI
Credential	:	MD
Telephone Number	:	972-223-7878

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	01/29/2016

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Directions to “GUARDIAN ANESTHESIA SERVICES & PAIN ” Practice Location

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