Organization
ETHEREAL ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN FOX (CEO)
(972) 588-4541
Entity
Organization
Contact information
Practice address
17101 DALLAS PKWY, ADDISON, TX 75001-7103
(469) 248-3900
(469) 304-0139
Mailing address
PO BOX 251606, PLANO, TX 75025-1510
(972) 588-4541
(469) 304-0139
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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