Organization
FRITZTOWN ANESTHESIA ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HICKS MD (AUTHORIZED REPRESENTATIVE)
(972) 715-5044
Entity
Organization
Contact information
Practice address
1020 S STATE HIGHWAY 16, FREDERICKSBURG, TX 78624-4471
(830) 997-4353
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(800) 242-1131
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
09/10/2013
Last updated
10/18/2013
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