Organization
ENDO SEDATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI WHEELER (ANESTHESIA SUPPORT SERVICES)
(817) 402-7526
Entity
Organization
Contact information
Practice address
1001 SURREY LN, FLOWER MOUND, TX 75022-4234
(817) 337-3671
(817) 912-1887
Mailing address
550 RESERVE ST STE 560, SOUTHLAKE, TX 76092-1607
(817) 402-7526
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C74Y
BCBS OF TEXAS
TX
Enumeration date
10/17/2012
Last updated
12/08/2022
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