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General NPI Number Information
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NPI Number | 1104803089
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Entity Type | Organization
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Legal Business Name | WAXAHACHIE ANESTHESIA CONSULTANT SERVICES PA
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 800 N HIGHWAY 77 SUITE 160 PMB #224
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1884
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Country | US
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Telephone | 972-937-7240
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Fax |
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Provider Business Mailing Address
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Address Line | 800 N HIGHWAY 77 SUITE 160 PMB 224
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1884
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Country | US
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Telephone | 972-937-7240
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Fax | 972-937-4255
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. PATTY WEATHERFORD
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Credential | CPC
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Telephone | 972-937-7240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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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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