Provider Demographics
NPI:1588640767
Name:KING, LUANNE DABBS (CRNA)
Entity Type:Individual
Prefix:MS
First Name:LUANNE
Middle Name:DABBS
Last Name:KING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LUANNE
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13601 PRESTON RD
Mailing Address - Street 2:SUITE 900W
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4911
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-386-4292
Practice Address - Street 1:5601 WARREN PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4069
Practice Address - Country:US
Practice Address - Phone:214-618-2002
Practice Address - Fax:214-618-2004
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654011367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX02688202Medicaid
TX02688202Medicaid
TX82013HMedicare ID - Type Unspecified606K
TX8A3990Medicare ID - Type Unspecified339K