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General NPI Number Information
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NPI Number | 1174761738
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Entity Type | Organization
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Legal Business Name | OPTIMA HEALTH RESOURCES LLC
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 5930 ROYAL LN SUITE E PMB 225
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City | DALLAS
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State | TX
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Zip | 75230-3896
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Country | US
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Telephone | 214-358-0920
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Fax | 214-902-9287
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Provider Business Mailing Address
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Address Line | 5930 ROYAL LN SUITE E PMB 225
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City | DALLAS
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State | TX
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Zip | 75230-3896
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Country | US
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Telephone | 214-358-0920
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Fax | 214-902-9287
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Authorized Official
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Title or Position | DIRECTOR
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Name | SUSAN BAHLS
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Credential |
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Telephone | 214-358-0920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State |
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