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General NPI Number Information
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NPI Number | 1306123195
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Entity Type | Organization
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Legal Business Name | SURGICAL ANESTHESIA MANAGEMENT OF TEXAS LLC
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 1815 NORTH STANTON
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City | EL PASO
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State | TX
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Zip | 79902-3511
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Country | US
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Telephone | 855-706-5542
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Fax | 706-650-1034
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Provider Business Mailing Address
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Address Line | PO BOX #204304
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City | DALLAS
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State | TX
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Zip | 75320-4304
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Country | US
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Telephone | 800-855-7065
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Fax | 706-650-1034
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW R. RIBAUDO
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Credential |
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Telephone | 404-446-1417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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