Organization
HERITAGE ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLA JEAN GROFF CRNA (PRESIDENT)
(212) 856-5624
Entity
Organization
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(214) 856-5624
Mailing address
8109 LINKSVIEW DR, MCKINNEY, TX 75070-2737
(214) 856-5624
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CO1451
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184989002
—
AR
Enumeration date
03/23/2010
Last updated
06/03/2014
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