Healthcare Provider Details

I. General information

NPI: 1003700246
Provider Name (Legal Business Name): LONGHORN ASSIST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 DEERWOOD PARK DR
ARLINGTON TX
76017-3744
US

IV. Provider business mailing address

PO BOX 187
FORT WORTH TX
76101-0187
US

V. Phone/Fax

Practice location:
  • Phone: 817-676-2292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GRANT ALLEN BOOHER
Title or Position: PRESIDENT
Credential: MD
Phone: 682-231-2366