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General NPI Number Information
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NPI Number | 1053850057
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Entity Type | Organization
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Legal Business Name | ESSA ANESTHESIA GROUP PLLC.
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 8111 MEADOW ROAD
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City | DALLAS
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State | TX
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Zip | 75231
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Country | US
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Telephone | 469-329-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 112
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City | MUNCIE
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State | IN
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Zip | 47308-0112
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Country | US
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Telephone | 765-284-0493
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Fax | 765-284-2434
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JOANNE ESSA
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Credential | MD
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Telephone | 972-400-0555
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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