Provider Demographics
NPI:1366106478
Name:SOUTHERN ANESTHESIA SERVICES, PLLC
Entity type:Organization
Organization Name:SOUTHERN ANESTHESIA SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:281-300-0078
Mailing Address - Street 1:1723 FLAT ROCK ST
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5482
Mailing Address - Country:US
Mailing Address - Phone:281-300-0078
Mailing Address - Fax:
Practice Address - Street 1:9180 KATY FWY # 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7454
Practice Address - Country:US
Practice Address - Phone:713-395-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty