Provider Demographics
NPI:1255835328
Name:GREATER HEIGHTS ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:GREATER HEIGHTS ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:STAVINOHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-869-8200
Mailing Address - Street 1:9101 LYNDON B JOHNSON FWY STE 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1912
Mailing Address - Country:US
Mailing Address - Phone:972-279-2570
Mailing Address - Fax:214-575-2245
Practice Address - Street 1:1631 NORTH LOOP W STE 655
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1599
Practice Address - Country:US
Practice Address - Phone:713-869-8200
Practice Address - Fax:713-687-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty