Provider Demographics
NPI:1558878975
Name:SP ANESTHESIA CONSULTANTS PLLC
Entity Type:Organization
Organization Name:SP ANESTHESIA CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-317-4301
Mailing Address - Street 1:5550 WARREN PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7399
Mailing Address - Country:US
Mailing Address - Phone:469-252-4777
Mailing Address - Fax:460-951-8215
Practice Address - Street 1:6300 W PARKER RD STE G25
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8105
Practice Address - Country:US
Practice Address - Phone:469-252-4777
Practice Address - Fax:469-518-2156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SPINE AND WELLNESS INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-08
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X, 261QP3300X
TXQ0953261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain