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General NPI Number Information
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NPI Number | 1376152165
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Entity Type | Organization
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Legal Business Name | DEEP SEDATION P.C.
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 825 E RUNDBERG LN STE A1
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City | AUSTIN
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State | TX
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Zip | 78753-4809
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Country | US
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Telephone | 909-304-0582
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 LAVACA ST # 724
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City | AUSTIN
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State | TX
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Zip | 78701-1634
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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 | PRESIDENT
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Name | CHAMANDEEP BRAR
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Credential |
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Telephone | 909-304-0582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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