Provider Demographics
NPI:1184201014
Name:ATHENS ANESTHESIA PLLC
Entity Type:Organization
Organization Name:ATHENS ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SEAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES-QUAIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-390-7697
Mailing Address - Street 1:960 RIDGEVIEW DRIVE
Mailing Address - Street 2:SUITE 140 - 261
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:214-390-7697
Mailing Address - Fax:972-432-6692
Practice Address - Street 1:8440 WALNUT HILL LN STE 230
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3816
Practice Address - Country:US
Practice Address - Phone:214-390-7697
Practice Address - Fax:972-432-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty