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Organization
WILLOW ANESTHESIA MANAGEMENT, LLC
Active
Organization
WILLOW ANESTHESIA MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (PRESIDENT)
(972) 234-4740
Entity
Organization
Contact information
Practice address
901 W 38TH ST STE 101, AUSTIN, TX 78705-1164
(512) 467-1100
(512) 371-5747
Mailing address
PO BOX 674430, DALLAS, TX 75267-4430
(512) 467-1100
(512) 371-8747
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/08/2016
Last updated
06/09/2016
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