Healthcare Provider Details
I. General information
NPI: 1649512096
Provider Name (Legal Business Name): SPRING CREEK ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2013
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
506 GRAHAM DR SUITE 240
TOMBALL TX
77375-3346
US
IV. Provider business mailing address
506 GRAHAM DR SUITE 240
TOMBALL TX
77375-3346
US
V. Phone/Fax
- Phone: 281-351-3830
- Fax: 281-351-6275
- Phone: 281-351-3830
- Fax: 281-351-6275
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: DR.
RAKA
CHAUHAN
GOHEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-351-3830