Provider Demographics
NPI:1285679811
Name:ANESTHESIA SAFETY FIRST PA
Entity Type:Organization
Organization Name:ANESTHESIA SAFETY FIRST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-885-9758
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75483-0678
Mailing Address - Country:US
Mailing Address - Phone:903-885-9758
Mailing Address - Fax:903-885-1052
Practice Address - Street 1:115 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2105
Practice Address - Country:US
Practice Address - Phone:903-885-9758
Practice Address - Fax:903-885-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171197001Medicaid
TX171197001Medicaid