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General NPI Number Information
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NPI Number | 1245814763
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Entity Type | Organization
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Legal Business Name | SEDATION PROFESSIONALS OF NORTH TEXAS PLLC
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1500 9TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4323
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Country | US
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Telephone | 940-761-9034
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Fax | 833-909-0623
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Provider Business Mailing Address
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Address Line | 3414 PEACHTREE RD NE STE 340
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City | ATLANTA
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State | GA
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Zip | 30326-1137
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Country | US
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Telephone | 425-803-3885
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Fax |
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Authorized Official
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Title or Position | VP OF RCM
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Name | JEFF PERRY
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Credential |
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Telephone | 425-803-3885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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