Provider Demographics
NPI:1902247539
Name:BARIATRIC ANESTHESIA ASSOCIATES, PLLC.
Entity Type:Organization
Organization Name:BARIATRIC ANESTHESIA ASSOCIATES, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BENAVIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-284-0493
Mailing Address - Street 1:PO BOX 674012
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4012
Mailing Address - Country:US
Mailing Address - Phone:765-284-0493
Mailing Address - Fax:765-284-2434
Practice Address - Street 1:610 N COIT RD
Practice Address - Street 2:SUITE 2120
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5474
Practice Address - Country:US
Practice Address - Phone:765-284-0493
Practice Address - Fax:765-284-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty