MEDICARE: TEXAS ELITE 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
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1396110813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS ELITE ANESTHESIA, PLLC

Provider Business Mailing Address
First Line	:	10150 MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-3219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10150 MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-3219
Country	:	US
Telephone Number	:	832-398-6467
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTIAN TRAN
Credential	:	MD
Telephone Number	:	832-398-6467

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	12/09/2015

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