Provider Demographics
NPI:1043294879
Name:BRENHAM ANESTHESIA ASSOCIATES PA
Entity Type:Organization
Organization Name:BRENHAM ANESTHESIA ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-481-3534
Mailing Address - Street 1:PO BOX 421209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1209
Mailing Address - Country:US
Mailing Address - Phone:713-481-3534
Mailing Address - Fax:713-432-0221
Practice Address - Street 1:700 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5413
Practice Address - Country:US
Practice Address - Phone:713-481-3534
Practice Address - Fax:713-432-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCF9301OtherRAILROAD MEDICARE
TXCF9301OtherRAILROAD MEDICARE