Healthcare Provider Details
I. General information
NPI: 1851908826
Provider Name (Legal Business Name): WOODHILL ANESTHESIA GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8315 WALNUT HILL LN STE 110
DALLAS TX
75231-4249
US
IV. Provider business mailing address
8315 WALNUT HILL LN STE 110
DALLAS TX
75231-4249
US
V. Phone/Fax
- Phone: 214-431-4244
- Fax:
- Phone: 214-363-9946
- Fax:
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:
JOHN
D
WALLACE
Title or Position: DOCTOR
Credential: MD, DDS
Phone: 214-363-9946