Provider Demographics
NPI:1609133669
Name:ALBERT ARREDONDO ANESTHESIA PLLC
Entity Type:Organization
Organization Name:ALBERT ARREDONDO ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ARREDONDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:210-386-8008
Mailing Address - Street 1:7801 NW BRADY WAY
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-0600
Mailing Address - Country:US
Mailing Address - Phone:210-386-8008
Mailing Address - Fax:
Practice Address - Street 1:4202 SW LEE BLVD
Practice Address - Street 2:BLDG B SUITE A
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8300
Practice Address - Country:US
Practice Address - Phone:580-699-8020
Practice Address - Fax:580-699-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK87300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty