Healthcare Provider Details
I. General information
NPI: 1346646577
Provider Name (Legal Business Name): NTX ASSIST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2014
Last Update Date: 11/18/2016
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
PO BOX 205663
DALLAS TX
75320-5663
US
V. Phone/Fax
- Phone: 817-485-5100
- Fax: 817-485-5101
- Phone: 817-485-5100
- Fax:
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