Basic Information
| Provider Information | |||||||||
| NPI: | 1750986501 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUT ANESTHESIA CARE ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9330 LBJ FWY STE 800 | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752434310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727925700 | ||||||||
| FaxNumber: | 8885103225 | ||||||||
| Practice Location | |||||||||
| Address1: | 15300 SOUTHWEST FWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774783827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8556778669 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2020 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| AuthorizedOfficialLastName: | KAW | ||||||||
| AuthorizedOfficialFirstName: | MADHUKAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7133024813 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.