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Organization

MICHIGAN ANESTHESIA CARE ONE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY KONDAS (OFFICER)
(973) 251-1132
Entity
Organization

Contact information

Practice address
13601 PRESTON RD, 1000W, DALLAS, TX 75240-4911
(972) 715-5000
Mailing address
PO BOX 660857, DALLAS, TX 75266-0857
(972) 715-5000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
208VP0014X
Interventional Pain Medicine Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
367500000X
Certified Registered Nurse Anesthetist

Other

Enumeration date
10/07/2010
Last updated
06/18/2020
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