Healthcare Provider Details
I. General information
NPI: 1033564620
Provider Name (Legal Business Name): APA MEDICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2016
Last Update Date: 11/21/2016
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
8840 CYPRESS WATERS BLVD SUITE 190
DALLAS TX
75019-4621
US
V. Phone/Fax
- Phone: 817-485-5100
- Fax: 972-573-5543
- Phone: 817-485-5100
- Fax: 972-573-5543
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLES
C
NEFF
Title or Position: DIRECTOR
Credential:
Phone: 817-485-5100