Sycamore Anesthesia Management, LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

SYCAMORE ANESTHESIA MANAGEMENT, LLC

Practice address

17051 Dallas Pkwy Ste 100
Addison, TX 75001-7102

Phone

(469) 916-0521

Fax

(972) 234-0212

NPI assigned

Jun 9, 2016

Organization subpart

No

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 2

Addresses

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1831548932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674423",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674423",
            "telephone_number": "469-916-0521",
            "fax_number": "972-234-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 DALLAS PKWY STE 100",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017102",
            "telephone_number": "469-916-0521",
            "fax_number": "972-234-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE ANESTHESIA MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "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": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lois Svach, OT
• Chihyin Tai
• Amy Tan
• Alexandra Taylor, MS, SLP-CF
• Charles Ted Taylor, R.PH.
• Dominique Taylor, COTA

• Certified Registered Nurse Anesthetist in Addison, TX
• Providers in Addison, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.