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General NPI Number Information
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NPI Number | 1174733927
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Entity Type | Organization
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Legal Business Name | GREENVILLE ANESTHESIA & PAIN MANAGEMENT, PLLC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4724 WELLINGTON ST
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City | GREENVILLE
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State | TX
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Zip | 75401-4944
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Country | US
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Telephone | 903-450-4300
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Fax | 972-862-1085
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Provider Business Mailing Address
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Address Line | PO BOX 504519
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City | SAINT LOUIS
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State | MO
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Zip | 63150-0001
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Country | US
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Telephone | 972-276-6300
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Fax | 972-862-1085
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Authorized Official
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Title or Position | OPERATIONS OFFICER
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Name | MRS. KRISIE WHISENANT
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Credential |
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Telephone | 214-537-3451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | TX
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