Provider Demographics
NPI:1558180083
Name:AFTERGLOW ANESTHESIA PLLC
Entity type:Organization
Organization Name:AFTERGLOW ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-864-5812
Mailing Address - Street 1:3737 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-7204
Mailing Address - Country:US
Mailing Address - Phone:817-516-8811
Mailing Address - Fax:817-516-8444
Practice Address - Street 1:3400 INTERSTATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2601
Practice Address - Country:US
Practice Address - Phone:817-516-8811
Practice Address - Fax:817-516-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty