MEDICARE: PHYSICIANS ANESTHESIA GROUP, LLP

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

General Provider Information

NPI Number	:	1942248067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS ANESTHESIA GROUP, LLP

Provider Business Mailing Address
First Line	:	6301 GASTON AVE
Second Line	:	EAST TOWER SUITE 400
City	:	DALLAS
State	:	TX
Zip	:	75214-3922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 GASTON AVE
Second Line	:	EAST TOWER SUITE 400
City	:	DALLAS
State	:	TX
Zip	:	75214-3922
Country	:	US
Telephone Number	:	214-217-8001
Fax Number	:

Authorized Official
Title or Position	:	CLIENT LIASON
Name	:	DONITA BILLINGS
Credential	:
Telephone Number	:	817-529-1931

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	09/05/2007

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