Provider Demographics
NPI:1083188825
Name:NITTANY ANESTHESIA PLLC
Entity Type:Organization
Organization Name:NITTANY ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-763-4209
Mailing Address - Street 1:1417 GABLES CT # 2001
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7648
Mailing Address - Country:US
Mailing Address - Phone:469-326-5115
Mailing Address - Fax:
Practice Address - Street 1:9301 N CENTRAL EXPY STE 685
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0816
Practice Address - Country:US
Practice Address - Phone:469-326-5115
Practice Address - Fax:469-326-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty