Healthcare Provider Details
I. General information
NPI: 1487106175
Provider Name (Legal Business Name): VERTEX ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2016
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4447 N CENTRAL EXPY SUITE 110-264
DALLAS TX
75205-4245
US
IV. Provider business mailing address
PO BOX 112
MUNCIE IN
47308-0112
US
V. Phone/Fax
- Phone: 970-420-3471
- Fax:
- Phone: 765-284-0493
- Fax: 765-284-2434
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATHER
M.
GANO
Title or Position: OWNER
Credential: MD
Phone: 214-707-3634