Provider Demographics
NPI:1184017741
Name:GCSA ANESTHESIA PLLC
Entity type:Organization
Organization Name:GCSA ANESTHESIA PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-1234
Mailing Address - Street 1:MCS #226
Mailing Address - Street 2:PO BOX 659831
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-9130
Mailing Address - Country:US
Mailing Address - Phone:210-614-1234
Mailing Address - Fax:210-614-0954
Practice Address - Street 1:5223 HAMILTON WOLFE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4463
Practice Address - Country:US
Practice Address - Phone:210-614-1234
Practice Address - Fax:210-614-0954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty