Provider Demographics
NPI:1154974384
Name:MODERN ANESTHESIA SOLUTIONS
Entity type:Organization
Organization Name:MODERN ANESTHESIA SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:U
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-390-7697
Mailing Address - Street 1:PO BOX 251253
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-1253
Mailing Address - Country:US
Mailing Address - Phone:214-390-7697
Mailing Address - Fax:888-770-6360
Practice Address - Street 1:1615 LANCASTER DR STE 150
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-2111
Practice Address - Country:US
Practice Address - Phone:214-390-7697
Practice Address - Fax:888-770-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty