MEDICARE: LEADING 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	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1699571851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEADING ANESTHESIA PLLC

Provider Business Mailing Address
First Line	:	7668 ELDORADO PKWY STE 300
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5753
Country	:	US
Telephone Number	:	972-999-1659
Fax Number	:	972-805-2777

Provider Business Practice Location Address
First Line	:	7668 ELDORADO PKWY STE 300
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5753
Country	:	US
Telephone Number	:	972-999-1659
Fax Number	:	972-805-2777

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MR. DAVID CLARK
Credential	:
Telephone Number	:	972-999-1659

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	02/19/2025

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