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General NPI Number Information
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NPI Number | 1366106478
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Entity Type | Organization
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Legal Business Name | SOUTHERN ANESTHESIA SERVICES, PLLC
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 9180 KATY FWY # 250
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City | HOUSTON
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State | TX
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Zip | 77055-7454
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Country | US
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Telephone | 713-395-1590
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Fax |
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Provider Business Mailing Address
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Address Line | 1723 FLAT ROCK ST
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5482
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Country | US
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Telephone | 281-300-0078
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. JOHN A. MERRITT
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Credential | CRNA
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Telephone | 281-300-0078
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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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