Organization · NPI-2
Agile Surgical Assistants, LLC
Physician Assistant, Surgical · Fort Worth, TX
NPI number1366976235
StatusActive
Last updated in NPPESApr 29, 2017
Details
- NPI
- 1366976235
- Entity type
- Organization (NPI-2)
- Legal business name
- Agile Surgical Assistants, LLC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2017
- Last updated
- Apr 29, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | SA00564 | TX |
Practice location
8428 Whippoorwill DrFort Worth, TX 76123-1996
Phone 817-713-8905 · Fax 817-394-1427
Mailing address
8428 Whippoorwill DrFort Worth, TX 76123-1996
Phone 817-713-8905 · Fax 817-394-1427
Authorized official
Sergio Giles
Chairman/Ceo
8177138905
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