Healthcare Provider Details

I. General information

NPI: 1891225330
Provider Name (Legal Business Name): GUIGNARD ANESTHESIA SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 06/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4261 E UNIVERSITY DR STE 30177
PROSPER TX
75078-9152
US

IV. Provider business mailing address

700 HIGHLANDER BLVD STE 415
ARLINGTON TX
76015-4346
US

V. Phone/Fax

Practice location:
  • Phone: 817-516-8811
  • Fax:
Mailing address:
  • Phone: 817-330-1102
  • Fax: 817-516-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JULI SMITH
Title or Position: CREDENTIALING COORDINATOR
Credential: CPC
Phone: 817-330-1102