Healthcare Provider Details

I. General information

NPI: 1669557617
Provider Name (Legal Business Name): RNFA SURGICAL SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13521 MANE CT
JUSTIN TX
76247
US

IV. Provider business mailing address

PO BOX 171
JUSTIN TX
76247-0171
US

V. Phone/Fax

Practice location:
  • Phone: 817-917-5651
  • Fax: 940-648-1293
Mailing address:
  • Phone: 940-648-3919
  • Fax: 940-648-3919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number686637
License Number StateTX

VIII. Authorized Official

Name: MRS. CHRISTINE J WALKER
Title or Position: REGISTERED NURSE, FIRST ASSISTANT
Credential: RN, RNFA, CNOR, CFA
Phone: 940-648-3919