NPIMap

Organization Active NPI

Sundance Anesthesia PA

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1760428361
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SUNDANCE ANESTHESIA PA
Practice address
6100 Harris Pkwy
Fort Worth, TX 76132-4101
Phone
(817) 433-5000
NPI assigned
Jun 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Bruce Leitch, MDNPI 1407833635
Title
President
Phone
(817) 731-2875

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 Primary

Addresses

Primary practice location

6100 Harris Pkwy
Fort Worth, TX 76132-4101

Mailing address

4200 S Hulen St
Suite 425
Fort Worth, TX 76109-4908
Phone (817) 731-2875

National Provider Directory

National Provider Directory

Locations

4200 S Hulen St
#1770
Fort Worth, TX 76109

4200 S Hulen St
Ste 425
Ft Worth, TX 76109
Phone (817) 731-2875

Practitioners & affiliated clinicians

Practitioners 130

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 130

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760428361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 S HULEN ST",
            "address_2": "SUITE 425",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094908",
            "telephone_number": "817-731-2875",
            "fax_number": "817-731-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324101",
            "telephone_number": "817-433-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE ANESTHESIA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEITCH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-731-2875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.