Provider Demographics
NPI:1770681009
Name:NEW ANESTHESIA PRACTICE SERVICE, P.A.
Entity Type:Organization
Organization Name:NEW ANESTHESIA PRACTICE SERVICE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-332-3664
Mailing Address - Street 1:PO BOX 2457
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76113-2457
Mailing Address - Country:US
Mailing Address - Phone:817-332-3664
Mailing Address - Fax:817-336-6440
Practice Address - Street 1:1401 HENDERSON ST
Practice Address - Street 2:SUITE 3
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-6026
Practice Address - Country:US
Practice Address - Phone:817-332-3664
Practice Address - Fax:817-336-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBCBSOther00C07T
TXBCBSOther00C07T