Organization
PHOENIX ANESTHESIA AND PAIN MANAGEMENT GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA C. TAYLOR-KENNEDY MD (DIRECTOR)
(214) 443-1240
Entity
Organization
Contact information
Practice address
14902 PRESTON RD, SUITE 404-745, DALLAS, TX 75254-9191
(214) 443-1240
(214) 443-1240
Mailing address
14902 PRESTON RD, SUITE 404-745, DALLAS, TX 75254-9191
(214) 443-1240
(214) 443-1240
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J2989
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
J2989
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS FACILITY 0042HW
LISA TAYLOR-KENNEDY, MD
TX
01
—
BCBS PROVIDER 8G0150
LISA TAYLOR-KENNEDY, MD
TX
Enumeration date
08/10/2006
Last updated
12/21/2007
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