Healthcare Provider Details

I. General information

NPI: 1760399869
Provider Name (Legal Business Name): ABIDE ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 HAMILTON AVE STE 101
FT WORTH TX
76107-1847
US

IV. Provider business mailing address

4455 CAMP BOWIE BLVD # 114-67
FT WORTH TX
76107-3826
US

V. Phone/Fax

Practice location:
  • Phone: 817-529-8488
  • Fax:
Mailing address:
  • Phone: 817-529-8488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CINDY BRANDON
Title or Position: RCM MANAGER
Credential:
Phone: 888-439-6560