Organization Active NPI

Aspen Anesthesia Management, LLC.

  • Pain Medicine (Anesthesiology) Physician
  • Southlake, TX
National Provider Identifier
1649708520
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
ASPEN ANESTHESIA MANAGEMENT, LLC.
Practice address
3065 W Southlake Blvd
Southlake, TX 76092-6730
Phone
(972) 234-4740
Fax
(972) 231-7095
NPI assigned
May 23, 2017
Last updated
May 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Tracy Walls
Title
President
Phone
(972) 234-4740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X TX Primary

Addresses

Primary practice location

3065 W Southlake Blvd
Southlake, TX 76092-6730

Mailing address

PO Box 674436
Dallas, TX 75267-4436
Phone (972) 234-4740

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1649708520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674436",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674436",
            "telephone_number": "972-234-4740",
            "fax_number": "972-231-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 W SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926730",
            "telephone_number": "972-234-4740",
            "fax_number": "972-231-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN ANESTHESIA MANAGEMENT, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-234-4740"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.