Provider Demographics
NPI:1447044318
Name:ELYSIUM ANESTHESIA PLLC
Entity type:Organization
Organization Name:ELYSIUM ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKEABIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-859-2638
Mailing Address - Street 1:610 S WATTERS RD STE 160
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5008
Mailing Address - Country:US
Mailing Address - Phone:469-251-8488
Mailing Address - Fax:469-498-6864
Practice Address - Street 1:610 S WATTERS RD STE 160
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5008
Practice Address - Country:US
Practice Address - Phone:469-251-8488
Practice Address - Fax:469-498-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty