Provider Demographics
NPI:1881825826
Name:HB ANESTHESIOLOGY CRNA GROUP
Entity Type:Organization
Organization Name:HB ANESTHESIOLOGY CRNA GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-838-2371
Mailing Address - Street 1:PO BOX 155808
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-5808
Mailing Address - Country:US
Mailing Address - Phone:936-639-3036
Mailing Address - Fax:936-639-3064
Practice Address - Street 1:505 S JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3120
Practice Address - Country:US
Practice Address - Phone:936-639-3036
Practice Address - Fax:936-639-3064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HB ANESTHESIOLOGY GROUP, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-06
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00022TMedicare PIN