MEDICARE: ALPHA ANESTHESIA

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	J5687	TX

General Provider Information

NPI Number	:	1639122211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA ANESTHESIA

Provider Business Mailing Address
First Line	:	PO BOX 975
Second Line	:
City	:	KEENE
State	:	TX
Zip	:	76059-0975
Country	:	US
Telephone Number	:	817-516-8811
Fax Number	:

Provider Business Practice Location Address
First Line	:	4275 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5618
Country	:	US
Telephone Number	:	817-516-8811
Fax Number	:	817-516-8444

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ERNEST ALVIN AQUI
Credential	:	MD
Telephone Number	:	817-800-9724

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	08/22/2020

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Directions to “ALPHA ANESTHESIA ” Practice Location

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