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
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 MedicinePain Medicine
Anesthesiology

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