Healthcare Provider Details

I. General information

NPI: 1679511307
Provider Name (Legal Business Name): WESTLAKE ANESTHESIA GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 BEE CAVES RD
AUSTIN TX
78746-5280
US

IV. Provider business mailing address

900 OLD KOENIG LN #123
AUSTIN TX
78756-1528
US

V. Phone/Fax

Practice location:
  • Phone: 936-639-3036
  • Fax:
Mailing address:
  • Phone: 936-639-3036
  • Fax: 936-639-3064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAUL A PLAYFAIR
Title or Position: MANAGER
Credential: MD
Phone: 936-639-3036