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General NPI Number Information
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NPI Number | 1154747681
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Entity Type | Organization
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Legal Business Name | METRO ANESTHESIA
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Dates
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Enumeration Date | 03/07/2014
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Last Update Date | 03/07/2014
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Provider Practice Location Address
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Address Line | 8204 ELMBROOK DR 175
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City | DALLAS
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State | TX
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Zip | 75247-4067
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Country | US
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Telephone | 817-834-8214
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Fax | 817-923-2913
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Provider Business Mailing Address
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Address Line | 6333 AIRPORT FWY 102
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City | FORT WORTH
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State | TX
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Zip | 76117-5323
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Country | US
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Telephone | 817-834-8214
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Fax | 817-923-2913
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL BROWN
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Credential |
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Telephone | 817-834-8214
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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 | E6117
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License Number State | TX
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