Provider Demographics
NPI:1710047840
Name:GARLAND ANESTHESIA CONSULTANTS, PA
Entity Type:Organization
Organization Name:GARLAND ANESTHESIA CONSULTANTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:972-276-6100
Mailing Address - Street 1:PO BOX 975684
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-5684
Mailing Address - Country:US
Mailing Address - Phone:972-276-6100
Mailing Address - Fax:972-276-1231
Practice Address - Street 1:1721 ANALOG DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1944
Practice Address - Country:US
Practice Address - Phone:972-276-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159462401Medicaid
TX00200UMedicare ID - Type UnspecifiedGAC