Provider Demographics
NPI:1982018529
Name:GRACE ANESTHESIA PLLC
Entity Type:Organization
Organization Name:GRACE ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIB-NABERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-517-1337
Mailing Address - Street 1:216 MECCA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 MECCA DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2209
Practice Address - Country:US
Practice Address - Phone:405-517-1337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty