Royal Blue Anesthesia PLLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

ROYAL BLUE ANESTHESIA PLLC

Practice address

5616 Warren Pkwy Suite 100
Frisco, TX 75034

Phone

(972) 999-1659

Fax

(972) 805-2777

NPI assigned

Jul 12, 2022

Organization subpart

No

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

Authorized official

Name

Mr. David Clark

Title

Billing Manager

Phone

(972) 999-1659

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1073247383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11625 CUSTER RD STE 110",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750358784",
            "telephone_number": "972-999-1659",
            "fax_number": "972-805-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 WARREN PKWY SUITE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75034",
            "telephone_number": "972-999-1659",
            "fax_number": "972-805-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL BLUE ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "972-999-1659",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Frisco, TX
• Providers in Frisco, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.