Provider Demographics
NPI:1093043507
Name:GOLDEN TRIANGLE ANESTHESIA SERVICES, PC
Entity Type:Organization
Organization Name:GOLDEN TRIANGLE ANESTHESIA SERVICES, PC
Other - Org Name:JOANNE LEWIS, CRNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:940-612-1511
Mailing Address - Street 1:1120 CHAPARRAL DR.
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240
Mailing Address - Country:US
Mailing Address - Phone:940-612-1511
Mailing Address - Fax:940-612-1511
Practice Address - Street 1:591 W. MAIN ST.
Practice Address - Street 2:LEWISVILLE SURGERY CENTER
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057
Practice Address - Country:US
Practice Address - Phone:972-420-0023
Practice Address - Fax:972-420-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX039687367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty