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NPI Code Detail

MEDICARE: SOUTHWEST FORT WORTH ANESTHESIA CONSULTANTS, PA

MEDICARE: SOUTHWEST FORT WORTH ANESTHESIA CONSULTANTS, PA
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 Anesthetist
2207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1942698337
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST FORT WORTH ANESTHESIA CONSULTANTS, PA
Provider Business Mailing Address
First Line : 4100 INTERNATIONAL PLZ
Second Line : SUITE 600
City : FORT WORTH
State : TX
Zip : 76109-4820
Country : US
Telephone Number : 817-334-0530
Fax Number : 817-529-1481
Provider Business Practice Location Address
First Line : 4100 INTERNATIONAL PLZ
Second Line : SUITE 600
City : FORT WORTH
State : TX
Zip : 76109-4820
Country : US
Telephone Number : 817-334-0530
Fax Number : 817-529-1481
Authorized Official
Title or Position : PRESIDENT
Name : C GORDON MCADAMS
Credential : MD
Telephone Number : 817-861-3994
Provider Enumeration Date : 01/07/2015
Last Update Date : 01/07/2015

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Directions to “SOUTHWEST FORT WORTH ANESTHESIA CONSULTANTS, PA ” Practice Location

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