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General NPI Number Information
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NPI Number | 1134084247
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Entity Type | Organization
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Legal Business Name | COVENANT ANESTHESIA MANAGEMENT PLLC
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Dates
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Enumeration Date | 12/20/2025
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 149 W STATE HIGHWAY 121 STE 105
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City | COPPELL
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State | TX
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Zip | 75019-2933
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Country | US
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Telephone | 972-833-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 621 DEERWOOD LN
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City | KELLER
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State | TX
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Zip | 76248-8481
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Country | US
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Telephone | 972-522-0098
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MALIA STEPHENSON
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Credential | CRNA
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Telephone | 972-533-0098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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