Basic Information
| Provider Information | |||||||||
| NPI: | 1881821536 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREENVILLE ANESTHESIA CONSULTANTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 WALTER REED BLVD STE 305 | ||||||||
| Address2: | |||||||||
| City: | GARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750423719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722766100 | ||||||||
| FaxNumber: | 9722761231 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 WALTER REED BLVD STE 305 | ||||||||
| Address2: | |||||||||
| City: | GARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750423719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722766100 | ||||||||
| FaxNumber: | 9722761231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2009 | ||||||||
| LastUpdateDate: | 06/19/2009 | ||||||||
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| AuthorizedOfficialLastName: | BURSON | ||||||||
| AuthorizedOfficialFirstName: | TERRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9722766100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.