Main Street Anesthesia of Texas, PA

NPI #1700381761 in Nacogdoches, Texas

Provider Information

NPI Number: 1700381761
Entity Type: Organization
Organization Name: Main Street Anesthesia of Texas, PA
Primary Specialty: Anesthesiology
Enumeration Date: Mar 29, 2018
Last Updated: Mar 29, 2018

Practice Location

Address: 4920 NE STALLINGS DR
City: Nacogdoches
State: Texas
ZIP Code: 75965-1254
Phone: (936) 569-9481

Authorized Official

Name: DAVID PATRICK LEACHMAN, MD
Title: PRESIDENT
Phone: (575) 644-1983

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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