Provider Demographics
NPI:1043636020
Name:HILLCREST ANESTHESIA, PLLC
Entity type:Organization
Organization Name:HILLCREST ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-529-2658
Mailing Address - Street 1:12890 HILLCREST RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1504
Mailing Address - Country:US
Mailing Address - Phone:972-573-0695
Mailing Address - Fax:
Practice Address - Street 1:4100 INTERNATIONAL PLZ
Practice Address - Street 2:SUITE 600
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4820
Practice Address - Country:US
Practice Address - Phone:817-529-2658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty