Healthcare Provider Details

I. General information

NPI: 1922349208
Provider Name (Legal Business Name): ALS ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 W ROYAL LN STE 196
IRVING TX
75063-1996
US

IV. Provider business mailing address

5005 W ROYAL LN STE 196
IRVING TX
75063-1996
US

V. Phone/Fax

Practice location:
  • Phone: 817-485-5100
  • Fax: 817-485-5101
Mailing address:
  • Phone: 817-485-5100
  • Fax: 817-485-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON CHRISTOPHER TINLEY
Title or Position: DIRECTOR
Credential: M.D.
Phone: 817-916-4685