Provider Demographics
NPI:1073991089
Name:ALLEGIANCE ANESTHESIOLOGY, PA
Entity Type:Organization
Organization Name:ALLEGIANCE ANESTHESIOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:DRAKE
Authorized Official - Last Name:AKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-969-2630
Mailing Address - Street 1:21126 COVINGTON BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-5315
Mailing Address - Country:US
Mailing Address - Phone:832-969-2630
Mailing Address - Fax:
Practice Address - Street 1:2217 PERSIMMON RIDGE CT
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2085
Practice Address - Country:US
Practice Address - Phone:512-423-3028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3221207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty