MEDICARE: TEJAS 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659383305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEJAS ANESTHESIA PLLC

Provider Business Mailing Address
First Line	:	PO BOX 744976
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-4976
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 GULF FWY S
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-5143
Country	:	US
Telephone Number	:	954-939-5000
Fax Number	:	866-250-6889

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	CHRISTOPHER KENNEDY
Credential	:
Telephone Number	:	207-807-9009

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	08/12/2025

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Directions to “TEJAS ANESTHESIA PLLC ” Practice Location

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