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NPI Code Detail

MEDICARE: NEW ANESTHESIA PRACTICE SERVICE, P.A.

MEDICARE: NEW ANESTHESIA PRACTICE SERVICE, P.A.
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
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BCBSOTHERTX00C07T

General Provider Information

NPI Number : 1770681009
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW ANESTHESIA PRACTICE SERVICE, P.A.
Provider Business Mailing Address
First Line : PO BOX 2457
Second Line :
City : FORT WORTH
State : TX
Zip : 76113-2457
Country : US
Telephone Number : 817-332-3664
Fax Number : 817-336-6440
Provider Business Practice Location Address
First Line : 1401 HENDERSON ST
Second Line : SUITE 3
City : FORT WORTH
State : TX
Zip : 76102-6026
Country : US
Telephone Number : 817-332-3664
Fax Number : 817-336-6440
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. EVA JO BAILEY
Credential : M.D.
Telephone Number : 817-332-3664
Provider Enumeration Date : 09/20/2006
Last Update Date : 08/22/2020

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Directions to “NEW ANESTHESIA PRACTICE SERVICE, P.A. ” Practice Location

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