Basic Information
| Provider Information | |||||||||
| NPI: | 1184139628 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHERN HILLS ANESTHESIA PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5999 CUSTER RD # 110-506 | ||||||||
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| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750359302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728408 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Practice Location | |||||||||
| Address1: | 7000 PRESTON RD STE 1500 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750242512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728254 | ||||||||
| FaxNumber: | 8887706360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2017 | ||||||||
| LastUpdateDate: | 10/05/2021 | ||||||||
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| AuthorizedOfficialLastName: | BARNES | ||||||||
| AuthorizedOfficialFirstName: | SHANNON | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 9728728254 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.