Basic Information
| Provider Information | |||||||||
| NPI: | 1912187535 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHPOINT ANESTHESIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3744 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785023744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566824151 | ||||||||
| FaxNumber: | 9566824154 | ||||||||
| Practice Location | |||||||||
| Address1: | 1305 E NOLANA AVE | ||||||||
| Address2: | SUITE H | ||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785046114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566824151 | ||||||||
| FaxNumber: | 9566824154 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2007 | ||||||||
| LastUpdateDate: | 11/12/2007 | ||||||||
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| AuthorizedOfficialLastName: | CANALES | ||||||||
| AuthorizedOfficialFirstName: | EDMUNDO | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 9566824151 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | G4889 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0074GW | 01 | TX | BCBS | OTHER |