Healthcare Provider Details

I. General information

NPI: 1578831186
Provider Name (Legal Business Name): FIRST ASSISTANTS & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5024 MEADOWBROOK DR
FT WORTH TX
76103-3423
US

IV. Provider business mailing address

PO BOX 938
ROWLETT TX
75030-0938
US

V. Phone/Fax

Practice location:
  • Phone: 214-227-2457
  • Fax: 972-463-7247
Mailing address:
  • Phone: 214-227-2457
  • Fax: 972-463-7247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License Number238441
License Number StateTX

VIII. Authorized Official

Name: MRS. SANDRA BUCKMASTER-BARBER
Title or Position: PROVIDER
Credential: RNFA
Phone: 214-227-2457