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General NPI Number Information
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NPI Number | 1174892517
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Entity Type | Organization
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Legal Business Name | PINNACLE ANESTHESIA CONSULTANTS PA
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 5757 WARREN PKWY SUITE 110
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City | FRISCO
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State | TX
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Zip | 75034-4274
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Country | US
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Telephone | 214-618-9600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 650426
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City | DALLAS
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State | TX
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Zip | 75265-0426
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Country | US
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Telephone | 972-715-5000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PROVIDER SERVICES
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Name | ANN SHORT
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Credential |
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Telephone | 972-715-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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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 #4
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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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