Provider Demographics
NPI:1720451248
Name:EVERGREEN ANESTHESIA PLLC
Entity Type:Organization
Organization Name:EVERGREEN ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-636-5727
Mailing Address - Street 1:811 S CENTRAL EXPY STE 103
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7439
Mailing Address - Country:US
Mailing Address - Phone:972-636-5727
Mailing Address - Fax:
Practice Address - Street 1:811 S CENTRAL EXPY STE 103
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-7439
Practice Address - Country:US
Practice Address - Phone:972-636-5727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6355207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty