Individual provider Active NPI

Amani Prince

  • Certified Registered Nurse Anesthetist
  • Kilgore, TX
National Provider Identifier
1780575068
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
990283 Issued in TX
Practice address
625 Highland Dr
Kilgore, TX 75662-3963
Phone
(903) 519-3954
NPI assigned
Jul 14, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 990283 TX Primary

Addresses

Primary practice location

625 Highland Dr
Kilgore, TX 75662-3963

Mailing address

625 Highland Dr
Kilgore, TX 75662-3963

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251122000037 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042702557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians
Vertex Anesthesia, PLLCGroup PAC ID 1052692324, 11 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-6356

610 N Coit Rd
2100 Vertex Anesthesia
Richardson, TX 75080-5462
Phone (972) 954-3588

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
990283TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Nov 10, 2025 Accepting new patients
Vertex Anesthesia, PLLC CurrentSince Aug 29, 2025 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Nov 10, 2025 Accepting new patients

Locations

17051 Dallas Pkwy
Ste 100
Addison, TX 75001
Phone (469) 718-5260

1401 E Trinity Mills Rd
Carrollton, TX 75006
Phone (972) 810-0700

3500 Gaston Ave
Dallas, TX 75246

4447 N Central Expy
Ste 110
Dallas, TX 75205
Phone (214) 707-3634

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

4708 Alliance Blvd
Ste 210
Plano, TX 75093
Phone (469) 800-6021

610 N Coit Rd
Ste 2100
Richardson, TX 75080
Phone 9405658580210

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1780575068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 HIGHLAND DR",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 HIGHLAND DR",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623963",
            "telephone_number": "903-519-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "AMANI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "990283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilgore, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.