Provider Demographics
NPI:1477752798
Name:OM ANESTHESIA PA
Entity Type:Organization
Organization Name:OM ANESTHESIA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:THAPAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-668-7460
Mailing Address - Street 1:PO BOX 295166
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75029-5166
Mailing Address - Country:US
Mailing Address - Phone:972-668-7460
Mailing Address - Fax:972-668-7467
Practice Address - Street 1:4312 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-8520
Practice Address - Country:US
Practice Address - Phone:972-668-7460
Practice Address - Fax:972-668-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6359207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty