Healthcare Provider Details
I. General information
NPI: 1912187535
Provider Name (Legal Business Name): NORTHPOINT ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/12/2007
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 E NOLANA AVE SUITE H
MCALLEN TX
78504-6114
US
IV. Provider business mailing address
PO BOX 3744
MCALLEN TX
78502-3744
US
V. Phone/Fax
- Phone: 956-682-4151
- Fax: 956-682-4154
- Phone: 956-682-4151
- Fax: 956-682-4154
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | G4889 |
| License Number State | TX |
VIII. Authorized Official
Name:
EDMUNDO
C
CANALES
Title or Position: OWNER/PROVIDER
Credential: M.D.
Phone: 956-682-4151