Pediatric Radioanesthesia Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

J5299 Issued in TX

Legal business name

PEDIATRIC RADIOANESTHESIA SUPPLY

Practice address

3200 Broadway Blvd
Suite 350
Garland, TX 75403

Phone

(972) 840-2804

Fax

(972) 840-2884

NPI assigned

May 20, 2009

Last updated

May 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. O R Davis, MD,PA

Title

Anesthesiologist

Phone

(972) 840-2804

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1578798468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 BROADWAY BLVD",
            "address_2": "SUITE 350",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431573",
            "telephone_number": "972-840-2804",
            "fax_number": "972-840-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 BROADWAY BLVD",
            "address_2": "SUITE 350",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75403",
            "telephone_number": "972-840-2804",
            "fax_number": "972-840-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC RADIOANESTHESIA SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "O",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ANESTHESIOLOGIST",
        "authorized_official_telephone_number": "972-840-2804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,PA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "J5299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Garland, TX
• Providers in Garland, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.