Healthcare Provider Details

I. General information

NPI: 1457674442
Provider Name (Legal Business Name): FIRST SURGICAL ANESTHESIA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2010
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 VISION PARK BLVD 200
SHENANDOAH TX
77384-3002
US

IV. Provider business mailing address

808 RUSSELL PALMER RD SUITE 151
KINGWOOD TX
77339-1689
US

V. Phone/Fax

Practice location:
  • Phone: 936-271-1011
  • Fax: 936-271-1016
Mailing address:
  • Phone: 281-540-7500
  • Fax: 281-540-7502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT CAMPBELL
Title or Position: MANAGER
Credential: MBA
Phone: 281-540-7500