Organization
GREENBELT ANESTHESIA ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN OFFUTT (PRESIDENT)
(817) 294-7444
Entity
Organization
Contact information
Practice address
7451 CHAPEL AVE, FORT WORTH, TX 76116-7090
(817) 294-7444
Mailing address
PO BOX 2626, FORT WORTH, TX 76113-2626
(817) 294-7444
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
231449
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126053103
—
TX
Enumeration date
10/24/2006
Last updated
01/10/2011
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