Basic Information
| Provider Information | |||||||||
| NPI: | 1023345261 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLEN AMBULATORY ANESTHESIA, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 813 ROLLING MEADOWS CT | ||||||||
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| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750135465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328222574 | ||||||||
| FaxNumber: | 9729083568 | ||||||||
| Practice Location | |||||||||
| Address1: | 4510 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE C-150 | ||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750691650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725471580 | ||||||||
| FaxNumber: | 8662157317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2009 | ||||||||
| LastUpdateDate: | 11/09/2009 | ||||||||
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| AuthorizedOfficialLastName: | EKANAYAKE | ||||||||
| AuthorizedOfficialFirstName: | IRANI | ||||||||
| AuthorizedOfficialMiddleName: | SHASHIKALA | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7328222574 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.