Organization
ASPEN ANESTHESIA MANAGEMENT, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (PRESIDENT)
(972) 234-4740
Entity
Organization
Contact information
Practice address
3065 W SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6730
(972) 234-4740
(972) 231-7095
Mailing address
PO BOX 674436, DALLAS, TX 75267-4436
(972) 234-4740
(972) 231-7095
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
TX
Other
Enumeration date
05/23/2017
Last updated
05/23/2017
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