Provider Demographics
NPI:1134165053
Name:BRAZORIA COUNTY ANESTHESIA, P.A.
Entity type:Organization
Organization Name:BRAZORIA COUNTY ANESTHESIA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-848-3068
Mailing Address - Street 1:146 E HOSPITAL DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4169
Mailing Address - Country:US
Mailing Address - Phone:979-848-3068
Mailing Address - Fax:979-849-1423
Practice Address - Street 1:146 E HOSPITAL DR
Practice Address - Street 2:SUITE 205
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4169
Practice Address - Country:US
Practice Address - Phone:979-848-3068
Practice Address - Fax:979-849-1423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCN9786OtherRAILROAD MEDICARE
TX090157102Medicaid
TX0057BMOtherBLUE SHIELD OF TEXAS
TX0057BMMedicare PIN