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NPI Code Detail

MEDICARE: PATRIOT ANESTHESIA

MEDICARE: PATRIOT ANESTHESIA
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
1367500000XCertified Registered Nurse AnesthetistAP119189TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
149654OTHERTXNBCRNA
2788451OTHERTXRN LICENSE

General Provider Information

NPI Number : 1720589310
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATRIOT ANESTHESIA
Provider Business Mailing Address
First Line : 700 HIGHLANDER BLVD STE 415
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-4346
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 700 HIGHLANDER BLVD STE 415
Second Line :
City : ARLINGTON
State : TX
Zip : 76015-4346
Country : US
Telephone Number : 817-516-8811
Fax Number :
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : ANITA ALANIZ
Credential :
Telephone Number : 469-218-0666
Provider Enumeration Date : 02/28/2018
Last Update Date : 02/28/2018

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Directions to “PATRIOT ANESTHESIA ” Practice Location

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