Provider Demographics
NPI:1912350976
Name:STRATUS DOMINION ANESTHESIA ASSOCIATES PLLC
Entity Type:Organization
Organization Name:STRATUS DOMINION ANESTHESIA ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEROTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-516-8811
Mailing Address - Street 1:25 HIGHLAND PARK VLG
Mailing Address - Street 2:SUITE 100765
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-2789
Mailing Address - Country:US
Mailing Address - Phone:817-516-8811
Mailing Address - Fax:817-516-8444
Practice Address - Street 1:25 HIGHLAND PARK VLG
Practice Address - Street 2:SUITE 100765
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-2789
Practice Address - Country:US
Practice Address - Phone:817-516-8811
Practice Address - Fax:817-516-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty