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General NPI Number Information
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NPI Number | 1346351640
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Entity Type | Organization
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Legal Business Name | MESQUITE ANESTHESIOLOGY ASSOCIATION, PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 3500 INTERSTATE 30
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City | MESQUITE
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State | TX
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Zip | 75150-2636
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Country | US
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Telephone | 972-698-3300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 870638
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City | MESQUITE
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State | TX
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Zip | 75187-0638
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Country | US
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Telephone | 972-681-7246
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Fax | 972-681-8946
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Authorized Official
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Title or Position | OWNER
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Name | DR. NAGARAJ S KIKKERI
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Credential | MD
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Telephone | 972-681-7246
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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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