Provider Demographics
NPI:1558736496
Name:KJ ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:KJ ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LONERGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-695-2757
Mailing Address - Street 1:PO BOX 780849
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-0849
Mailing Address - Country:US
Mailing Address - Phone:855-882-2849
Mailing Address - Fax:801-931-2044
Practice Address - Street 1:14603 HUEBNER RD
Practice Address - Street 2:BLDG 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230
Practice Address - Country:US
Practice Address - Phone:210-695-2757
Practice Address - Fax:800-520-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty