Provider Demographics
NPI:1407496235
Name:V15 ANESTHESIA PLLC
Entity Type:Organization
Organization Name:V15 ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-244-9101
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:TX
Mailing Address - Zip Code:76073-0190
Mailing Address - Country:US
Mailing Address - Phone:469-713-9353
Mailing Address - Fax:940-626-4455
Practice Address - Street 1:4447 N CENTRAL EXPY STE 110-264
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4245
Practice Address - Country:US
Practice Address - Phone:214-415-4262
Practice Address - Fax:214-292-9332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty