Provider Demographics
NPI:1518599943
Name:PRINCIPLEMED ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:PRINCIPLEMED ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIETER
Authorized Official - Suffix:III
Authorized Official - Credentials:NP
Authorized Official - Phone:832-524-5355
Mailing Address - Street 1:16840 BUCCANEER LN STE 261
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2570
Mailing Address - Country:US
Mailing Address - Phone:832-932-5968
Mailing Address - Fax:832-532-6119
Practice Address - Street 1:5010 CRENSHAW RD STE 130
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4615
Practice Address - Country:US
Practice Address - Phone:281-991-2200
Practice Address - Fax:281-991-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty