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1700837408

NPI Code Detail

MEDICARE: ANESTHESIOLOGISTS FOR CHILDREN

MEDICARE: ANESTHESIOLOGISTS FOR CHILDREN

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	101YP2500X	Professional Counselor
2	103T00000X	Psychologist
3	1041C0700X	Clinical Social Worker
4	106H00000X	Marriage & Family Therapist
5	207L00000X	Anesthesiology Physician
6	207LH0002X	Hospice and Palliative Medicine (Anesthesiology) Physician
7	208VP0014X	Interventional Pain Medicine Physician
8	2251P0200X	Pediatric Physical Therapist
9	207LP2900X	Pain Medicine (Anesthesiology) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	TXB147969	OTHER	TX	MEDICARE ID-TYPE UNSPECIFIED

Other Identifiers

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

General Provider Information

NPI Number	:	1700837408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIOLOGISTS FOR CHILDREN

Provider Business Mailing Address
First Line	:	1935 MEDICAL DISTRICT DR
Second Line	:	ST9.08
City	:	DALLAS
State	:	TX
Zip	:	75235-7701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 MEDICAL DISTRICT DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7701
Country	:	US
Telephone Number	:	214-456-6921
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHEN KIMATIAN
Credential	:	MD
Telephone Number	:	214-456-6393

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	05/01/2023

Similar Medicare Providers

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Practice Location Address:

1935 MEDICAL DISTRICT DR
DALLAS, TX
75235-7701

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1407786734 — CALLIE LANGWORTHY HORNBUCKLE MS, CGC
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75235-7701

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1710817085 — SARAH MONTGOMERY
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1679950737 — CHARLES ODOM M.D.
Practice Location Address:

1935 MEDICAL DISTRICT DR
DALLAS, TX
75235-7701

Practice Phone: 214-456-8899
Practice Fax: 214-456-5986

1982532941 — MR. AARON SAMADZADAH CAA
Practice Location Address:

1935 MEDICAL DISTRICT DR
DALLAS, TX
75235-7701

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Practice Fax:

1992279566 — JILLIAN LEIGH FROST PNP
Practice Location Address:

1935 MEDICAL DISTRICT DR
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1295786010 — DR. JESSE DADSON MD
Practice Location Address:

1935 MEDICAL DISTRICT DR , DEPARTMENT OF ANESTHESIOLOGY
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75235-7701

Practice Phone: 214-456-6393
Practice Fax: 214-456-7232

Directions to “ANESTHESIOLOGISTS FOR CHILDREN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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