Provider Demographics
NPI:1790368470
Name:LA LA LAND ANESTHESIA
Entity Type:Organization
Organization Name:LA LA LAND ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-977-8608
Mailing Address - Street 1:LAURIE SMITH, CRNA
Mailing Address - Street 2:2902 WOODSIDE STREET
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:972-270-2066
Mailing Address - Fax:866-507-7848
Practice Address - Street 1:SURGERY CENTER OF TEXAS
Practice Address - Street 2:6020 W. PLANO PARKWAY
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-563-2477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty