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NPI Code Detail

MEDICARE: HILLCREST ANESTHESIA, PLLC

MEDICARE: HILLCREST ANESTHESIA, 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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1043636020
Entity Type Code : Organization
Provider Name (Legal Business Name) : HILLCREST ANESTHESIA, PLLC
Provider Business Mailing Address
First Line : 12890 HILLCREST RD
Second Line : SUITE 203
City : DALLAS
State : TX
Zip : 75230-1504
Country : US
Telephone Number : 972-573-0695
Fax Number :
Provider Business Practice Location Address
First Line : 4100 INTERNATIONAL PLZ
Second Line : SUITE 600
City : FORT WORTH
State : TX
Zip : 76109-4820
Country : US
Telephone Number : 817-529-2658
Fax Number :
Authorized Official
Title or Position : DELEGATED OFFICIAL
Name : PAM SIMMONS
Credential :
Telephone Number : 817-529-2658
Provider Enumeration Date : 03/13/2014
Last Update Date : 03/13/2014

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Directions to “HILLCREST ANESTHESIA, PLLC ” Practice Location

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