Organization Active NPI

MKT Anesthesia

  • Anesthesiology Physician
  • Katy, TX
National Provider Identifier
1376082867
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
N5462 Issued in TX
Legal business name
MKT ANESTHESIA
Practice address
24608 Kinglsand Blvd
Katy, TX 77494-3386
Phone
(281) 665-8552
Fax
(281) 665-8559
NPI assigned
Feb 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Dr. Sebastian VillarrealNPI 1497930044
Title
Medical Doctor
Phone
(281) 665-8552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X N5462 TX Primary

Addresses

Primary practice location

24608 Kinglsand Blvd
Katy, TX 77494-3386

Mailing address

24608 Kinglsand Blvd
Katy, TX 77494-3386
Phone (281) 665-8552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170428001973 TX Part B Supplier - Clinic/Group Practice 1153608153 Receives reassigned benefits from 3 practitioners
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

24608 Kingsland Blvd
Katy, TX 77494
Phone (281) 665-8552

Practitioners & affiliated clinicians

Practitioners 3

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": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1376082867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24608 KINGLSAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943386",
            "telephone_number": "281-665-8552",
            "fax_number": "281-665-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24608 KINGLSAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943386",
            "telephone_number": "281-665-8552",
            "fax_number": "281-665-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKT ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "281-665-8552",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "N5462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.