Healthcare Provider Details

I. General information

NPI: 1922441815
Provider Name (Legal Business Name): HPA ANESTHESIA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 MAIN ST STE 410
HOUSTON TX
77030-4456
US

IV. Provider business mailing address

7700 MAIN ST STE 410
HOUSTON TX
77030-4456
US

V. Phone/Fax

Practice location:
  • Phone: 214-295-6703
  • Fax: 214-245-5267
Mailing address:
  • Phone: 214-295-6703
  • Fax: 214-245-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ADRIANNA VILLARREAL
Title or Position: ADMIN
Credential:
Phone: 214-295-6703