Organization
HAWTHORN 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
17051 DALLAS PKWY STE 100, ADDISON, TX 75001-7102
(469) 916-0521
(972) 234-0212
Mailing address
PO BOX 674427, DALLAS, TX 75267-4427
(469) 916-0521
(972) 234-0212
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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