Provider Demographics
NPI:1629027511
Name:NORTHWEST ANESTHESIOLOGY & PAIN SERVICES, P.A.
Entity Type:Organization
Organization Name:NORTHWEST ANESTHESIOLOGY & PAIN SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BETHEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-698-5320
Mailing Address - Street 1:7010 CHAMPIONS PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2396
Mailing Address - Country:US
Mailing Address - Phone:832-698-5331
Mailing Address - Fax:
Practice Address - Street 1:7010 CHAMPIONS PLAZA DR
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2396
Practice Address - Country:US
Practice Address - Phone:832-698-5331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110813602Medicaid
TX110813604Medicaid
TX110813601Medicaid
TX110813602Medicaid
TX110813601Medicaid