Healthcare Provider Details

I. General information

NPI: 1144241977
Provider Name (Legal Business Name): BRAZORIA COUNTY ANESTHESIA P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E HOSPITAL DR SUITE 205
ANGLETON TX
77515-4169
US

IV. Provider business mailing address

146 E HOSPITAL DR SUITE 205
ANGLETON TX
77515-4169
US

V. Phone/Fax

Practice location:
  • Phone: 979-848-3068
  • Fax: 979-849-1423
Mailing address:
  • Phone: 979-848-3068
  • Fax: 979-849-1423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: RITA RANDHAWA
Title or Position: OFFICE MANAGER
Credential:
Phone: 979-848-3068