Provider Demographics
NPI:1821659830
Name:ADAM ANESTHESIA PLLC
Entity Type:Organization
Organization Name:ADAM ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-326-5115
Mailing Address - Street 1:1417 GABLES CT # 201
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7648
Mailing Address - Country:US
Mailing Address - Phone:469-326-5115
Mailing Address - Fax:469-326-5119
Practice Address - Street 1:8000 ELDORADO PKWY STE A
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4136
Practice Address - Country:US
Practice Address - Phone:469-326-5115
Practice Address - Fax:469-326-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty