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General NPI Number Information
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NPI Number | 1932590817
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Entity Type | Organization
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Legal Business Name | TOP O TEXAS ANESTHESIOLOGY SERVICES
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 1420 CORONADO DR
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City | PAMPA
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State | TX
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Zip | 79065-4602
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Country | US
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Telephone | 409-939-9358
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 CORONADO DR
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City | PAMPA
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State | TX
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Zip | 79065-4602
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Country | US
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Telephone | 409-939-9358
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | JESSIE COLEMAN
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Credential | MD
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Telephone | 409-939-9358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | Q1377
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License Number State | TX
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