Healthcare Provider Details

I. General information

NPI: 1497087357
Provider Name (Legal Business Name): PROASSIST SURGICAL ASSOCIATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 ALMA DR STE 105
PLANO TX
75025-3483
US

IV. Provider business mailing address

7801 ALMA DR STE 105
PLANO TX
75025-3483
US

V. Phone/Fax

Practice location:
  • Phone: 214-714-7010
  • Fax:
Mailing address:
  • Phone: 214-714-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License NumberN/A
License Number State

VIII. Authorized Official

Name: ONICHAMAKA LSABELLA OJIRIKA
Title or Position: SURGICAL FIRST ASSIST
Credential:
Phone: 214-536-7913