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General NPI Number Information
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NPI Number | 1487682852
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Entity Type | Organization
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Legal Business Name | ANESTHESIA SERVICES OF SOUTHEAST TEXAS
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 608 STICKLAND DEPARTMENT OF ANESTHESIA
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City | ORANGE
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State | TX
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Zip | 77630
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Country | US
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Telephone | 915-760-6144
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 741928
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City | DALLAS
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State | TX
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Zip | 75374-1928
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Country | US
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Telephone | 915-760-6144
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Fax |
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | CARLOS F FRANCO
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Credential |
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Telephone | 915-760-6144
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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 | RN537368
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License Number State | TX
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