Provider Demographics
NPI:1225024706
Name:ANESTHESIOLOGY CONSULTANTS OF HOUSTON PLLC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY CONSULTANTS OF HOUSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TEODULO
Authorized Official - Middle Name:
Authorized Official - Last Name:AVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-827-1820
Mailing Address - Street 1:PO BOX 203824
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-3824
Mailing Address - Country:US
Mailing Address - Phone:281-358-8114
Mailing Address - Fax:281-358-0609
Practice Address - Street 1:8850 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3006
Practice Address - Country:US
Practice Address - Phone:713-827-1820
Practice Address - Fax:713-468-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7874207L00000X, 207LP2900X
367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00091KOtherBLUE CROSS BLUE SHIELD
TX090104302Medicaid
TXCN6330OtherRAILROAD MEDICARE
TX00090KOtherBLUE CROSS BLUE SHIELD
TX090104301Medicaid
TX090104301Medicaid
TX090104302Medicaid