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Organization
REPUBLIC ANESTHESIA LLC
Active
Organization
REPUBLIC ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GASKIN (PRESIDENT)
(979) 777-8400
Entity
Organization
Contact information
Practice address
3134 BRIARCREST DR, BRYAN, TX 77802-3014
(979) 777-8400
Mailing address
10592 COUNTY ROAD 175, IOLA, TX 77861-3617
(979) 777-8400
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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