Southlake Premier Anesthesia, Pllc
NPI #1710524095 in Fort Worth, Texas
Provider Information
- NPI Number
- 1710524095
- Entity Type
- Organization
- Organization Name
- Southlake Premier Anesthesia, Pllc
- Primary Specialty
- Anesthesiology
- Enumeration Date
- Dec 5, 2019
- Last Updated
- Dec 5, 2019
Practice Location
- Address
- 3200 N TARRANT PKWY
- City
- Fort Worth
- State
- Texas
- ZIP Code
- 76177-8611
- Phone
- (210) 996-6363
Authorized Official
- Name
- EVERLY MILLER
- Title
- CREDENTIALING SPECIALIST
- Phone
- (210) 996-6363
Specialties & Taxonomy Codes
| Specialty |
|---|
| Anesthesiology - Pain Medicine — Pain Medicine |
| Anesthesiology |
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