Basic Information
Provider Information
NPI: 1588042899
EntityType: 2
ReplacementNPI:  
OrganizationName: LUXE ANESTHESIA, PLLC
LastName:  
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Mailing Information
Address1: 5706 E MOCKINGBIRD LN STE 115
Address2:  
City: DALLAS
State: TX
PostalCode: 752065461
CountryCode: US
TelephoneNumber: 2149454582
FaxNumber:  
Practice Location
Address1: 5706 E MOCKINGBIRD LN STE 115
Address2:  
City: DALLAS
State: TX
PostalCode: 752065461
CountryCode: US
TelephoneNumber: 2149454582
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/07/2015
LastUpdateDate: 01/25/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: HAJIBASHI
AuthorizedOfficialFirstName: SHAHEEN
AuthorizedOfficialMiddleName: JOHN
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 2149454582
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate: 01/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XP6406TXY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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