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General NPI Number Information
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NPI Number | 1265418222
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER ANESTHESIA ASSOCIATES PA
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 2424 W HOLCOMBE BLVD STE 205
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City | HOUSTON
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State | TX
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Zip | 77030-1934
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Country | US
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Telephone | 713-790-9412
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Fax | 713-790-9738
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Provider Business Mailing Address
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Address Line | 2424 W HOLCOMBE BLVD STE 205
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City | HOUSTON
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State | TX
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Zip | 77030-1934
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Country | US
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Telephone | 713-790-9412
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Fax | 713-790-9738
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | JENNIFER L TODD
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Credential |
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Telephone | 713-790-9412
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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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