Ethereal Anesthesia PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

ETHEREAL ANESTHESIA PLLC

Practice address

17101 Dallas Pkwy
Addison, TX 75001-7103

Phone

(469) 248-3900

Fax

(469) 304-0139

NPI assigned

Jun 22, 2022

Organization subpart

No

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

Authorized official

Name

Brian Fox

Title

Ceo

Phone

(972) 588-4541

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1346971025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251606",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251510",
            "telephone_number": "972-588-4541",
            "fax_number": "469-304-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 DALLAS PKWY",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017103",
            "telephone_number": "469-248-3900",
            "fax_number": "469-304-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEREAL ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-588-4541"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Emerson, LPC; LMFT
• Amanda Emmet
• Enlil Medical Center LLC
• Yelena C Enwere, PT
• Kiewanna Erskine
• Shakesha Montina Evans, PHD
• Elizabeth Farris, M.S., CCC-SLP
• Dwain R Faso
• Elizabeth Faulkner
• Kati Ann Faulkner, M.S. SLP-INTERN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.