Provider Demographics
NPI:1649355223
Name:SLEEPWIND ANESTHESIA, PA
Entity type:Organization
Organization Name:SLEEPWIND ANESTHESIA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:432-272-4368
Mailing Address - Street 1:4916 OVERTON PLZ
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4415
Mailing Address - Country:US
Mailing Address - Phone:817-334-0530
Mailing Address - Fax:817-334-0235
Practice Address - Street 1:515 ADAMS AVE
Practice Address - Street 2:DEPT OF ANESTHESIOLOGY
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4613
Practice Address - Country:US
Practice Address - Phone:888-550-1904
Practice Address - Fax:432-550-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00563VMedicare ID - Type Unspecified