Healthcare Provider Details

I. General information

NPI: 1255562021
Provider Name (Legal Business Name): USM ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 RIVER POINTE DR STE 240
CONROE TX
77304-2861
US

IV. Provider business mailing address

PO BOX 898
CONROE TX
77305-0898
US

V. Phone/Fax

Practice location:
  • Phone: 936-494-3003
  • Fax:
Mailing address:
  • Phone: 936-494-3003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: KATHY LYN HOWARD
Title or Position: MANAGER
Credential:
Phone: 936-494-3003