Provider Demographics
NPI:1760770341
Name:ALLIANCE ANESTHESIA
Entity Type:Organization
Organization Name:ALLIANCE ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:ALBORES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:504-915-1077
Mailing Address - Street 1:2248 POTOMAC DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4919
Mailing Address - Country:US
Mailing Address - Phone:504-915-1077
Mailing Address - Fax:
Practice Address - Street 1:1717 DAKOTA DR
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4739
Practice Address - Country:US
Practice Address - Phone:504-915-1077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801491367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty