Organization Active NPI

MTC Anesthesia, LLP

  • Certified Registered Nurse Anesthetist
  • Dallas, TX
National Provider Identifier
1073546792
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MTC ANESTHESIA, LLP
Practice address
9301 N Central Expy
Dallas, TX 75231-0806
Phone
(214) 265-2810
Fax
(214) 265-2820
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Teresa Dianne Gardner, CRNA
Title
General Partner
Phone
(214) 320-3975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

9301 N Central Expy
Dallas, TX 75231-0806

Mailing address

5027 Lilac LN
Dallas, TX 75209-3329

Other identifiers 1

IdentifierTypeStateIssuer
00C91SOtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073546792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5027 LILAC LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752093329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 N CENTRAL EXPY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310806",
            "telephone_number": "214-265-2810",
            "fax_number": "214-265-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTC ANESTHESIA, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "DIANNE",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "214-320-3975",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00C91S",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.