Provider Demographics
NPI:1598173783
Name:IN LINE ANESTHESIA SERVICES LP
Entity Type:Organization
Organization Name:IN LINE ANESTHESIA SERVICES LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:713-291-4188
Mailing Address - Street 1:PO BOX 70289
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77270
Mailing Address - Country:US
Mailing Address - Phone:173-291-4188
Mailing Address - Fax:
Practice Address - Street 1:3618 STANFORD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-4644
Practice Address - Country:US
Practice Address - Phone:713-291-4188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX047047367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047047OtherAANA