Organization
ECSC IV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R NOBACK MD (MEMBER)
(941) 360-1566
Entity
Organization
Contact information
Practice address
6124 W PARKER RD, #232, PLANO, TX 75093-8122
(469) 467-0100
Mailing address
PO BOX 864483, ORLANDO, FL 32886-4483
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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