MEDICARE: ANESTHESIA BY AC PA

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	800731223	TX

General Provider Information

NPI Number	:	1386978203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA BY AC PA

Provider Business Mailing Address
First Line	:	3701 ENCANTO DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3547
Country	:	US
Telephone Number	:	817-614-7062
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 ENCANTO DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3547
Country	:	US
Telephone Number	:	817-614-7062
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALLEN JAMES CASTELL
Credential	:	M.D.
Telephone Number	:	817-614-7062

Provider Enumeration Date	:	09/24/2009
Last Update Date	:	09/24/2009

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Directions to “ANESTHESIA BY AC PA ” Practice Location

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