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General NPI Number Information
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NPI Number | 1881821536
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Entity Type | Organization
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Legal Business Name | GREENVILLE ANESTHESIA CONSULTANTS
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 700 WALTER REED BLVD STE 305
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City | GARLAND
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State | TX
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Zip | 75042-3719
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Country | US
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Telephone | 972-276-6100
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Fax | 972-276-1231
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Provider Business Mailing Address
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Address Line | 700 WALTER REED BLVD STE 305
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City | GARLAND
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State | TX
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Zip | 75042-3719
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Country | US
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Telephone | 972-276-6100
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Fax | 972-276-1231
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TERRIE BURSON
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Credential |
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Telephone | 972-276-6100
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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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