| NPI | 1174671614 |
|---|---|
| Other Name | BOONEVILLE ANESTHESIA SERVICES |
| Entity Type | Organization |
| Authorized Contact | TERRENCE BRANDON JOHNSON President 469-235-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |