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General NPI Number Information
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NPI Number | 1003700246
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Entity Type | Organization
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Legal Business Name | LONGHORN ASSIST PLLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 5005 DEERWOOD PARK DR
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City | ARLINGTON
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State | TX
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Zip | 76017-3744
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Country | US
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Telephone | 817-676-2292
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | FORT WORTH
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State | TX
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Zip | 76101-0187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRANT ALLEN BOOHER
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Credential | MD
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Telephone | 682-231-2366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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