Provider Demographics
NPI:1881821536
Name:GREENVILLE ANESTHESIA CONSULTANTS
Entity Type:Organization
Organization Name:GREENVILLE ANESTHESIA CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-276-6100
Mailing Address - Street 1:700 WALTER REED BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-3719
Mailing Address - Country:US
Mailing Address - Phone:972-276-6100
Mailing Address - Fax:972-276-1231
Practice Address - Street 1:700 WALTER REED BLVD STE 305
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-3719
Practice Address - Country:US
Practice Address - Phone:972-276-6100
Practice Address - Fax:972-276-1231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty