Basic Information
Provider Information
NPI: 1376778472
EntityType: 2
ReplacementNPI:  
OrganizationName: GREATER HOUSTON ANESTHESIOLOGY
LastName:  
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Mailing Information
Address1: 5353 MEMORIAL DR
Address2: # 2025
City: HOUSTON
State: TX
PostalCode: 770078266
CountryCode: US
TelephoneNumber: 7134199958
FaxNumber:  
Practice Location
Address1: 2411 FOUNTAIN VIEW DR
Address2: SUITE 200
City: HOUSTON
State: TX
PostalCode: 770574817
CountryCode: US
TelephoneNumber: 7136204000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2009
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: FURGESON
AuthorizedOfficialFirstName: EVIE
AuthorizedOfficialMiddleName: MICHELLE
AuthorizedOfficialTitleorPosition: SRNA
AuthorizedOfficialTelephone: 7134199958
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XXTXY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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