Healthcare Provider Details
I. General information
NPI: 1215497508
Provider Name (Legal Business Name): BD ANESTHESIA ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/22/2019
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2024 W 15TH ST # F-364
PLANO TX
75075-7363
US
IV. Provider business mailing address
2024 W 15TH ST # F-364
PLANO TX
75075-7363
US
V. Phone/Fax
- Phone: 214-817-4226
- Fax: 469-754-0416
- Phone: 972-370-5771
- Fax: 469-754-0416
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367H00000X |
| Taxonomy | Anesthesiologist Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMEER
SYED
Title or Position: OWNER
Credential: MD
Phone: 972-370-5771