Provider Demographics
NPI:1295816478
Name:LAZARUS ANESTHESIA ASSOCIATES INC.
Entity Type:Organization
Organization Name:LAZARUS ANESTHESIA ASSOCIATES INC.
Other - Org Name:PAIN MANAGEMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:505-461-4434
Mailing Address - Street 1:714 MESQUITE
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401
Mailing Address - Country:US
Mailing Address - Phone:505-461-4434
Mailing Address - Fax:505-461-4435
Practice Address - Street 1:614 S 2ND ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2864
Practice Address - Country:US
Practice Address - Phone:505-461-1461
Practice Address - Fax:505-461-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03039320005261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center