Provider Demographics
NPI:1811971526
Name:EAST HOUSTON ANESTHESIA PLLC
Entity type:Organization
Organization Name:EAST HOUSTON ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REP.
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:AQUILINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-481-3534
Mailing Address - Street 1:PO BOX 421209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13111 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5820
Practice Address - Country:US
Practice Address - Phone:713-481-3534
Practice Address - Fax:713-432-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCI2165OtherRAILROAD MEDICARE
TX00U12QMedicare ID - Type UnspecifiedGROUP NUMBER
TX00C82JMedicare ID - Type UnspecifiedCRNA GROUP NUMBER