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Organization
PREMIUM ANESTHESIA, PLLC
Active
Organization
PREMIUM ANESTHESIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A RUSSELL (CEO)
(512) 413-2425
Entity
Organization
Contact information
Practice address
8015 SHOAL CREEK BLVD STE 100, DOING BUSINESS AT CENTER FOR SPECIAL SURGERY, AUSTIN, TX 78757-8051
(936) 639-3036
Mailing address
PO BOX 153608, LUFKIN, TX 75915-3608
(936) 639-3036
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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