Organization
MTC ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN RICHARDS CRNA (CRNA)
(817) 294-7444
Entity
Organization
Contact information
Practice address
9301 N CENTRAL EXPY, DALLAS, TX 75231-0806
(214) 265-2810
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C92U
BCBS TX
TX
Enumeration date
02/24/2009
Last updated
04/21/2009
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