Provider Demographics
NPI:1720852205
Name:METRO ANESTHESIOLOGY AFFILIATES, PLLC
Entity Type:Organization
Organization Name:METRO ANESTHESIOLOGY AFFILIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:DELILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNA, NSPM-C
Authorized Official - Phone:817-966-2762
Mailing Address - Street 1:1800 SABLE BAY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1304
Mailing Address - Country:US
Mailing Address - Phone:817-966-2762
Mailing Address - Fax:682-270-0829
Practice Address - Street 1:1800 SABLE BAY LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76005-1304
Practice Address - Country:US
Practice Address - Phone:817-966-2762
Practice Address - Fax:682-270-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty