Provider Demographics
NPI:1356451850
Name:PRIME CARE ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:PRIME CARE ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:325-829-7799
Mailing Address - Street 1:2009 CYNTHIA COURT
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-5245
Mailing Address - Country:US
Mailing Address - Phone:325-829-7799
Mailing Address - Fax:
Practice Address - Street 1:2009 CYNTHIA COURT
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-5245
Practice Address - Country:US
Practice Address - Phone:325-829-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX231244367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00C73SOtherBCBS GROUP #
TX00127ZMedicare ID - Type UnspecifiedMEDICARE GROUP #