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General NPI Number Information
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NPI Number | 1053740084
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Entity Type | Organization
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Legal Business Name | AVANTI ANESTHESIA, PA
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 2855 GRAMERCY ST
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City | HOUSTON
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State | TX
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Zip | 77025-1756
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Country | US
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Telephone | 713-668-6828
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Fax |
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Provider Business Mailing Address
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Address Line | 2726 BISSONNET ST STE 240-506
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City | HOUSTON
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State | TX
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Zip | 77005-1319
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Country | US
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Telephone | 832-377-7648
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Fax | 866-391-2754
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAGGIE A JEFFRIES
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Credential | MD
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Telephone | 832-377-7648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | E5059
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License Number State | TX
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