Provider Demographics
NPI:1790377133
Name:PROVIDENCE ANESTHESIA SERVICES PLLC
Entity Type:Organization
Organization Name:PROVIDENCE ANESTHESIA SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-738-3441
Mailing Address - Street 1:7520 MALABAR LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2412
Mailing Address - Country:US
Mailing Address - Phone:214-738-3441
Mailing Address - Fax:
Practice Address - Street 1:7520 MALABAR LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2412
Practice Address - Country:US
Practice Address - Phone:214-738-3441
Practice Address - Fax:888-746-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730253048OtherNPI