Basic Information
| Provider Information | |||||||||
| NPI: | 1801564851 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LAKOTA ANESTHESIA SERVICE PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 702095 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753702095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729991659 | ||||||||
| FaxNumber: | 2057295887 | ||||||||
| Practice Location | |||||||||
| Address1: | 8380 WARREN PKWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750344199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729991659 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2021 | ||||||||
| LastUpdateDate: | 09/03/2021 | ||||||||
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| AuthorizedOfficialLastName: | MORCHOWER | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5042373739 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.