Healthcare Provider Details

I. General information

NPI: 1487608691
Provider Name (Legal Business Name): BAY AREA ANESTHESIA SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 MEDICAL CENTER BLVD
WEBSTER TX
77598-4220
US

IV. Provider business mailing address

PO BOX 73265
HOUSTON TX
77273-3265
US

V. Phone/Fax

Practice location:
  • Phone: 281-580-9030
  • Fax: 281-580-2725
Mailing address:
  • Phone: 281-580-9030
  • Fax: 281-580-2725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateTX

VIII. Authorized Official

Name: IRENE FONTENOT
Title or Position: ADMINISTRATOR
Credential:
Phone: 281-580-9030