Provider Demographics
NPI:1053561407
Name:I CARE ANESTHESIA, PLLC
Entity type:Organization
Organization Name:I CARE ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:PERPETUA
Authorized Official - Last Name:MARESH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:956-286-3701
Mailing Address - Street 1:6620 GRANDE BAY
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2017
Mailing Address - Country:US
Mailing Address - Phone:956-286-3701
Mailing Address - Fax:956-729-0480
Practice Address - Street 1:5313 MCPHERSON RD
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6832
Practice Address - Country:US
Practice Address - Phone:956-568-5441
Practice Address - Fax:956-568-5443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710725367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty