Healthcare Provider Details

I. General information

NPI: 1992120133
Provider Name (Legal Business Name): AMS PARIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 02/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 PINE MILL RD
PARIS TX
75460-3469
US

IV. Provider business mailing address

6094 14TH ST W STE 192
BRADENTON FL
34207-4104
US

V. Phone/Fax

Practice location:
  • Phone: 941-360-1566
  • Fax: 941-358-9818
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateTX

VIII. Authorized Official

Name: DAVID W. SIMPSON
Title or Position: MEMBER
Credential: MD
Phone: 941-360-1566