# PROFESSIONAL ANESTHESIA GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619149648
- **Authorized official:** BRIAN P WOODS MD (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (214) 687-0015

## Contact information

- **Practice address:** 1500 DIXON ST STE 101, FREDERICKSBURG, VA 22401-7231
- **Practice address phone:** (540) 371-5349
- **Practice address fax:** (540) 373-1745
- **Mailing address:** PO BOX 222037, DALLAS, TX 75222-2037
- **Mailing address phone:** (239) 610-0775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 03/31/2008
- **Last updated:** 05/25/2021