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General NPI Number Information
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NPI Number | 1528178019
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Entity Type | Organization
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Legal Business Name | ENTERPRISE ANESTHESIA SERVICES, PLLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 5602 HEALTH CENTER DR
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City | ABILENE
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State | TX
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Zip | 79606-1227
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Country | US
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Telephone | 325-793-3755
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Fax | 325-793-3750
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Provider Business Mailing Address
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Address Line | 3301 S 14TH ST STE 16180
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City | ABILENE
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State | TX
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Zip | 79605-5015
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Country | US
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Telephone | 325-675-6466
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Fax | 325-692-6030
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | POPPY A WALKER
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Credential | MBA
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Telephone | 325-675-6466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 595335
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License Number State | TX
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