MEDICARE: PPC TEXAS ANESTHESIA 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	261QR1100X	Research Clinic/Center
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1932790631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PPC TEXAS ANESTHESIA PLLC

Provider Business Mailing Address
First Line	:	960 RIDGEVIEW DRIVE
Second Line	:	STE 140 - 241
City	:	ALLEN
State	:	TX
Zip	:	75013
Country	:	US
Telephone Number	:	214-390-7697
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 W CAMPBELL RD STE 305
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-3468
Country	:	US
Telephone Number	:	214-390-7697
Fax Number	:	972-432-6690

Authorized Official
Title or Position	:	ADMIN
Name	:	RAO KAMRAN ALI
Credential	:
Telephone Number	:	214-390-7697

Provider Enumeration Date	:	01/27/2021
Last Update Date	:	12/02/2025

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