Longview Assist PLLC
Physician Assistant, Surgical in Longview, TX. Organization (NPI-2).
NPI number1316536733
StatusActive
Last updated in NPPESFeb 10, 2021
Details
- NPI
- 1316536733
- Entity type
- Organization (NPI-2)
- Legal business name
- Longview Assist PLLC
- Organization subpart
- No
- Enumeration date
- Jan 11, 2021
- Certification date
- Feb 10, 2021
- Last updated
- Feb 10, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
Practice location
700 E Marshall AveLongview, TX 75601-5580
Phone 817-756-8236
Mailing address
510 E Loop 281 Ste B #626Longview, TX 75605-5076
Phone 817-756-8232
Authorized official
Rekha Wagle
Npi Administrator
8177568232
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