Provider Demographics
NPI:1538433578
Name:TEXANS ANESTHESIA ASSOCIATES, PLLC
Entity type:Organization
Organization Name:TEXANS ANESTHESIA ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/M.D
Authorized Official - Prefix:MR
Authorized Official - First Name:TEODULO
Authorized Official - Middle Name:
Authorized Official - Last Name:AVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-588-7020
Mailing Address - Street 1:PO BOX 421969
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1969
Mailing Address - Country:US
Mailing Address - Phone:713-559-6929
Mailing Address - Fax:713-559-6928
Practice Address - Street 1:21406 PROVINCIAL BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7587
Practice Address - Country:US
Practice Address - Phone:888-839-7246
Practice Address - Fax:713-571-7246
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXANS ANESTHESIA ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195054501Medicaid
TX00Y441OtherMEDICARE