Provider Demographics
NPI:1316596919
Name:DALLAS ANESTHESIA GROUP, PLLC
Entity Type:Organization
Organization Name:DALLAS ANESTHESIA GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHEEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HAJIBASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-945-4582
Mailing Address - Street 1:5706 E. MOCKINGBIRD LN
Mailing Address - Street 2:STE 115
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206
Mailing Address - Country:US
Mailing Address - Phone:214-945-4582
Mailing Address - Fax:
Practice Address - Street 1:5706 E. MOCKINGBIRD LN
Practice Address - Street 2:STE 115
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206
Practice Address - Country:US
Practice Address - Phone:214-945-4582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty