MEDICARE: ULTIMATE ANESTHESIA SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1013747922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE ANESTHESIA SERVICES PLLC

Provider Business Mailing Address
First Line	:	25312 INTERSTATE 45 N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1449
Country	:	US
Telephone Number	:	346-331-2554
Fax Number	:	346-331-2543

Provider Business Practice Location Address
First Line	:	25312 INTERSTATE 45 N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1449
Country	:	US
Telephone Number	:	346-331-2554
Fax Number	:	346-331-2543

Authorized Official
Title or Position	:	OWNER
Name	:	RAVI MOPARTY
Credential	:	MD
Telephone Number	:	832-326-8032

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	01/07/2026

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