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General NPI Number Information
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NPI Number | 1104285279
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Entity Type | Organization
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Legal Business Name | VICTORY FIRST ASSISTANTS, LLC
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 412 ROUNDROCK LN
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City | FORT WORTH
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State | TX
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Zip | 76140-6547
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Country | US
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Telephone | 817-886-3466
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Fax |
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Provider Business Mailing Address
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Address Line | 412 ROUNDROCK LN
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City | FORT WORTH
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State | TX
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Zip | 76140-6547
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Country | US
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Telephone | 817-886-3466
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTORIANO PARILLA
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Credential | BSN, RN, CNOR, RNFA
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Telephone | 817-682-3792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 211D00000X
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Taxonomy Name | Podiatric Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WS0121X
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Taxonomy Name | Plastic Surgery Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number |
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License Number State |
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