Provider Demographics
NPI:1588906812
Name:VALIANT ANESTHESIA ASSOCIATES, PLLC
Entity type:Organization
Organization Name:VALIANT ANESTHESIA ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-694-7888
Mailing Address - Street 1:PO BOX 204823
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-4823
Mailing Address - Country:US
Mailing Address - Phone:972-694-7888
Mailing Address - Fax:
Practice Address - Street 1:14850 QUORUM DR STE 440
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7001
Practice Address - Country:US
Practice Address - Phone:972-694-7888
Practice Address - Fax:214-301-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026YROtherBLUE CROSS BLUE SHIELD
TX326640501Medicaid