Basic Information
| Provider Information | |||||||||
| NPI: | 1891285367 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHWEST HOUSTON ANESTHESIA, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9101 LYNDON B JOHNSON FWY STE 710 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752431912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727925700 | ||||||||
| FaxNumber: | 2145752245 | ||||||||
| Practice Location | |||||||||
| Address1: | 17520 W GRAND PKWY S | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774794758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817255970 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2018 | ||||||||
| LastUpdateDate: | 05/10/2018 | ||||||||
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| AuthorizedOfficialLastName: | JAFRI | ||||||||
| AuthorizedOfficialFirstName: | NADIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2817255970 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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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.