Provider Demographics
NPI:1346293800
Name:SOUTHEAST ANESTHESIA & PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:SOUTHEAST ANESTHESIA & PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ADOLFO
Authorized Official - Last Name:DUARTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-324-9400
Mailing Address - Street 1:PO BOX 140105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-0105
Mailing Address - Country:US
Mailing Address - Phone:214-324-9400
Mailing Address - Fax:214-324-9402
Practice Address - Street 1:1110 N BUCKNER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3487
Practice Address - Country:US
Practice Address - Phone:214-324-9400
Practice Address - Fax:214-324-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty