MEDICARE: NTX ANESTHESIOLOGY CONSULTANTS 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		TX

General Provider Information

NPI Number	:	1912410739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NTX ANESTHESIOLOGY CONSULTANTS PLLC

Provider Business Mailing Address
First Line	:	2221 LAKESIDE BLVD STE 600
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-4416
Country	:	US
Telephone Number	:	972-422-5941
Fax Number	:	972-881-4390

Provider Business Practice Location Address
First Line	:	2400 N I 35
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5240
Country	:	US
Telephone Number	:	855-285-2455
Fax Number	:	972-881-4390

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MARK ETTINGER
Credential	:	MD
Telephone Number	:	469-607-2276

Provider Enumeration Date	:	11/15/2017
Last Update Date	:	03/11/2026

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