=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760190508
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEADFAST ANESTHESIA ASSOCIATES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2022
-----------------------------------------------------
Last Update Date | 08/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1805 KINSALE DR
-----------------------------------------------------
City | KELLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76262-9023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-966-2762
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1805 KINSALE DR
-----------------------------------------------------
City | KELLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76262-9023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-966-2762
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. ROBERT LOUIS DELILLO
-----------------------------------------------------
Credential | DNP, CRNA, NSPM-C
-----------------------------------------------------
Telephone | 817-966-2762
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------