Provider Demographics
NPI: | 1649512096 |
---|---|
Name: | SPRING CREEK ANESTHESIA, PLLC |
Entity type: | Organization |
Organization Name: | SPRING CREEK ANESTHESIA, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | RAKA |
Authorized Official - Middle Name: | CHAUHAN |
Authorized Official - Last Name: | GOHEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 281-351-3830 |
Mailing Address - Street 1: | 506 GRAHAM DR |
Mailing Address - Street 2: | SUITE 240 |
Mailing Address - City: | TOMBALL |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77375-3346 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 281-351-3830 |
Mailing Address - Fax: | 281-351-6275 |
Practice Address - Street 1: | 506 GRAHAM DR |
Practice Address - Street 2: | SUITE 240 |
Practice Address - City: | TOMBALL |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77375-3346 |
Practice Address - Country: | US |
Practice Address - Phone: | 281-351-3830 |
Practice Address - Fax: | 281-351-6275 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-03-25 |
Last Update Date: | 2013-03-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 367H00000X | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant | Group - Single Specialty |