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General NPI Number Information
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NPI Number | 1285742288
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Entity Type | Organization
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Legal Business Name | D AND T ANESTHESIA
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 621 N HALL ST
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City | DALLAS
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State | TX
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Zip | 75226-1339
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Country | US
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Telephone | 214-820-0600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 631745
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City | IRVING
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State | TX
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Zip | 75063-0028
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Country | US
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Telephone | 214-696-3540
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Fax | 214-696-1230
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUCAS NJO
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Credential | M.D.
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Telephone | 214-696-3540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | L5075
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License Number State | TX
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