Organization
RAVEN ANESTHESIA MANAGEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON JOHNSON (PRESIDENT/CEO)
(866) 488-0513
Entity
Organization
Contact information
Practice address
1401 ST JOSEPH PKWY, HOUSTON, TX 77002-8301
(866) 488-0513
(903) 374-4711
Mailing address
PO BOX 742976, DALLAS, TX 75374-2976
(866) 488-0513
(903) 374-4711
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/16/2007
Last updated
07/25/2011
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