Provider Demographics
NPI:1073226247
Name:SUPREME ANESTHESIA PARTNERS
Entity Type:Organization
Organization Name:SUPREME ANESTHESIA PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:214-450-9926
Mailing Address - Street 1:8616 GREENVILLE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7166
Mailing Address - Country:US
Mailing Address - Phone:214-450-9926
Mailing Address - Fax:
Practice Address - Street 1:8616 GREENVILLE AVE STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7166
Practice Address - Country:US
Practice Address - Phone:214-450-9926
Practice Address - Fax:469-646-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty