Lake Time Crna

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

661498 Issued in TX

Legal business name

LAKE TIME CRNA

Practice address

9301 N Central Expy
Suite 1000W
Dallas, TX 75231-0806

Phone

(214) 265-2810

NPI assigned

Feb 4, 2016

Organization subpart

No

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

Authorized official

Name

Cece Pannell

Title

Off MGR

Phone

(817) 294-7444

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1518325513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2626",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761132626",
            "telephone_number": "817-294-7444",
            "fax_number": "817-294-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 N CENTRAL EXPY",
            "address_2": "SUITE 1000W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310806",
            "telephone_number": "214-265-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE TIME CRNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "PANNELL",
        "authorized_official_first_name": "CECE",
        "authorized_official_title_or_position": "OFF MGR",
        "authorized_official_telephone_number": "817-294-7444"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "661498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake House Home Health Agency, LLC
• Lake June Dental PLLC
• Lake June Medical Center, P.a.
• Lake June SRGM PLLC
• Lake Meadow Dental Group PLLC
• Amy Lake
• Kimberly J Lake, DDS
• Lakehill Preparatory School: Health and Wellness Center
• Lakeshia Kijuan Ealy (Gentle Hands Home Health Care)
• Lakeshore Anesthesia Group, PLLC

• Certified Registered Nurse Anesthetist in Dallas, TX
• Providers in Dallas, 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 Apr 11, 2016; 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.