Fredericksburg Anesthesia Consultants PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

FREDERICKSBURG ANESTHESIA CONSULTANTS PLLC

Practice address

1020 S State Highway 16
Fredericksburg, TX 78624-4471

Phone

(830) 997-4353

NPI assigned

Jul 15, 2010

Last updated

Sep 13, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Ray Hicks, MD

Title

Cmo/President

Phone

(954) 838-2371

Specialties & licenses 7

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1043523384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650802",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650802",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S STATE HIGHWAY 16",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244471",
            "telephone_number": "830-997-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKSBURG ANESTHESIA CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CMO/PRESIDENT",
        "authorized_official_telephone_number": "954-838-2371",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219219701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.