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General NPI Number Information
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NPI Number | 1336892439
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Entity Type | Organization
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Legal Business Name | FOUNDATION ANESTHESIA, PLLC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 8390 LYNDON B JOHNSON FWY # 500
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City | DALLAS
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State | TX
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Zip | 75243-1188
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Country | US
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Telephone | 469-214-5735
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Fax |
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Provider Business Mailing Address
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Address Line | 8390 LYNDON B JOHNSON FWY # 500
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City | DALLAS
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State | TX
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Zip | 75243-1188
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN HULL THOMPSON
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Credential | MD
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Telephone | 817-739-0433
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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 |
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License Number State |
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