=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942308549
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DALLAS ANESTHESIOLOGY GROUP PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7622 ROYAL PL
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-361-5680
-----------------------------------------------------
Fax | 214-739-3358
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 821388-314
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75382
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-361-5680
-----------------------------------------------------
Fax | 214-739-3358
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CATALINA ESPURAUZA GARCIA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 214-725-1517
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------