Basic Information
| Provider Information | |||||||||
| NPI: | 1093043507 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOLDEN TRIANGLE ANESTHESIA SERVICES, PC | ||||||||
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| OtherOrganizationName: | JOANNE LEWIS, CRNA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1120 CHAPARRAL DR. | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406121511 | ||||||||
| FaxNumber: | 9406121511 | ||||||||
| Practice Location | |||||||||
| Address1: | 591 W. MAIN ST. | ||||||||
| Address2: | LEWISVILLE SURGERY CENTER | ||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724200023 | ||||||||
| FaxNumber: | 9724200731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2009 | ||||||||
| LastUpdateDate: | 11/20/2009 | ||||||||
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| AuthorizedOfficialLastName: | LEWIS | ||||||||
| AuthorizedOfficialFirstName: | JOANNE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9406121511 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 039687 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.