Organization · NPI-2

117 Surgical Assistants, PLLC

Physician Assistant · Coppell, TX

NPI number1760928576
StatusActive
Last updated in NPPESJan 18, 2017

Details

NPI
1760928576
Entity type
Organization (NPI-2)
Legal business name
117 Surgical Assistants, PLLC
Organization subpart
No
Enumeration date
Jan 18, 2017
Last updated
Jan 18, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant––Yes

Practice location

8840 Cypress Waters Blvd Ste 190
Coppell, TX 75019-4621

Phone 817-485-5100

Mailing address

8840 Cypress Waters Blvd Ste 190
Coppell, TX 75019-4621

Phone 817-485-5100

Authorized official

Charles C Neff
Director
8174855100

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