Provider Demographics
NPI:1326485509
Name:ANESTHESIOLOGY PRACTICE ASSISTANCE INC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY PRACTICE ASSISTANCE INC
Other - Org Name:FERNANDO T. AVILA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:T
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:210-212-8280
Mailing Address - Street 1:3702 BLACKSTONE RUN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2750
Mailing Address - Country:US
Mailing Address - Phone:210-223-1181
Mailing Address - Fax:210-226-1268
Practice Address - Street 1:1017 N MAIN AVE
Practice Address - Street 2:1023
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4723
Practice Address - Country:US
Practice Address - Phone:210-212-8280
Practice Address - Fax:210-212-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX550868135OtherTAX ID
TX742609895OtherTAX ID