Healthcare Provider Details
I. General information
NPI: 1467980706
Provider Name (Legal Business Name): ECT ANESTHESIA OF TEXAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/31/2017
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2025 GUADALUPE ST STE 260
AUSTIN TX
78705-5642
US
IV. Provider business mailing address
111 TOWN SQUARE PL STE 420
JERSEY CITY NJ
07310-1724
US
V. Phone/Fax
- Phone: 888-589-8550
- Fax: 201-604-6571
- Phone: 888-589-8550
- Fax: 201-604-6571
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HAROON
W
CHAUDHRY
Title or Position: PRESIDENT
Credential: MD
Phone: 917-621-6854