Healthcare Provider Details

I. General information

NPI: 1003364621
Provider Name (Legal Business Name): U S ANESTHESIA PARTNERS OF TEXAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6707 STERLING RIDGE DR STE C
SPRING TX
77382-2773
US

IV. Provider business mailing address

PO BOX 650865
DALLAS TX
75265-0865
US

V. Phone/Fax

Practice location:
  • Phone: 713-597-5841
  • Fax: 713-987-7691
Mailing address:
  • Phone: 972-715-1999
  • Fax: 972-715-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: TIFFANY JOLLEY
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 713-620-4000