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General NPI Number Information
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NPI Number | 1770160616
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Entity Type | Organization
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Legal Business Name | ADDISON ANESTHESIA PLLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 17051 DALLAS PKWY STE 100
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City | ADDISON
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State | TX
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Zip | 75001-7102
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Country | US
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Telephone | 972-502-9981
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Fax | 888-590-6624
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Provider Business Mailing Address
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Address Line | PO BOX 260195
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City | PLANO
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State | TX
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Zip | 75026-0195
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Country | US
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Telephone | 972-502-9981
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY MYOUNG
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Credential | MD
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Telephone | 972-502-9981
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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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