NPIMap

Organization Active NPI

Wichita Falls Anesthesia PLLC

  • Anesthesiology Physician
  • Wichita Falls, TX
National Provider Identifier
1639636210
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
WICHITA FALLS ANESTHESIA PLLC
Practice address
1600 11TH St
Wichita Falls, TX 76301-4300
Phone
(940) 764-7000
NPI assigned
Mar 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Authorized official

Name
Ryan Gray, MDNPI 1649461823
Title
Managing Employee
Phone
(940) 235-0242

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: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1600 11TH St
Wichita Falls, TX 76301-4300

Mailing address

Dept 42053, PO Box 650823
Dallas, TX 75265-0823

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190508002236 TX Part B Supplier - Clinic/Group Practice 7012259260 Receives reassigned benefits from 77 practitioners
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 78

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

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1639636210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 42053, PO BOX 650823",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 11TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014300",
            "telephone_number": "940-764-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA FALLS ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "940-235-0242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.