Provider Demographics
NPI:1821487067
Name:STARWOOD ANESTHESIA PLLC
Entity Type:Organization
Organization Name:STARWOOD ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:TARIQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-507-2365
Mailing Address - Street 1:3308 PRESTON RD
Mailing Address - Street 2:SUITE 350 # 261
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7453
Mailing Address - Country:US
Mailing Address - Phone:214-507-2365
Mailing Address - Fax:
Practice Address - Street 1:7589 PRESTON RD
Practice Address - Street 2:SUITE 900
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5667
Practice Address - Country:US
Practice Address - Phone:214-705-7749
Practice Address - Fax:214-705-7729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41543367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Multi-Specialty