Provider Demographics
NPI:1780982603
Name:NORTHWEST ANESTHESIA & PAIN SERVICES
Entity type:Organization
Organization Name:NORTHWEST ANESTHESIA & PAIN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGGIERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-698-5331
Mailing Address - Street 1:7010 CHAMPIONS PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2396
Mailing Address - Country:US
Mailing Address - Phone:832-698-5330
Mailing Address - Fax:832-698-5321
Practice Address - Street 1:9303 PINECROFT DR
Practice Address - Street 2:SUITE 310
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3181
Practice Address - Country:US
Practice Address - Phone:281-296-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty