Healthcare Provider Details
I. General information
NPI: 1003228768
Provider Name (Legal Business Name): APA MEDICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2014
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5005 W ROYAL LN SUITE 196
IRVING TX
75063-1996
US
IV. Provider business mailing address
5005 W ROYAL LN SUITE 196
IRVING TX
75063-1996
US
V. Phone/Fax
- Phone: 817-485-5100
- Fax: 817-485-5101
- Phone: 817-485-5100
- Fax: 817-485-5101
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLES
NEFF
Title or Position: DIRECTOR
Credential:
Phone: 817-485-5100