Healthcare Provider Details

I. General information

NPI: 1376322495
Provider Name (Legal Business Name): SNOWMASS ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4090 MAPLESHADE LN STE 100
PLANO TX
75093-0025
US

IV. Provider business mailing address

4090 MAPLESHADE LN STE 100
PLANO TX
75093-0025
US

V. Phone/Fax

Practice location:
  • Phone: 972-435-4002
  • Fax:
Mailing address:
  • Phone: 972-435-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BABER YOUNAS
Title or Position: OWNER
Credential: M.D
Phone: 972-435-4002