Provider Demographics
NPI:1245623099
Name:WAXAHACHIE ANESTHESIA ASSOCIATES
Entity type:Organization
Organization Name:WAXAHACHIE ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA, DNP
Authorized Official - Phone:972-921-7416
Mailing Address - Street 1:PO BOX T
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75168-1107
Mailing Address - Country:US
Mailing Address - Phone:972-921-7416
Mailing Address - Fax:
Practice Address - Street 1:PO BOX T
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75168-1107
Practice Address - Country:US
Practice Address - Phone:972-921-7416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN 236996163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory CareGroup - Single Specialty