Provider Demographics
NPI:1760190508
Name:STEADFAST ANESTHESIA ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:STEADFAST ANESTHESIA ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUKENIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-567-2633
Mailing Address - Street 1:825 WATTERS CREEK BLVD
Mailing Address - Street 2:BUILDING M, SUITE 250
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 WATTERS CREEK BLVD
Practice Address - Street 2:BUILDING M, SUITE 250
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:817-966-2762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty