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General NPI Number Information
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NPI Number | 1316450604
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Entity Type | Organization
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Legal Business Name | IDEAL ASSIST, PLLC
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 3044 OLD DENTON RD STE 111 #307
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City | CARROLLTON
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State | TX
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Zip | 75007-5074
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Country | US
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Telephone | 469-283-0496
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Fax |
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Provider Business Mailing Address
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Address Line | 3044 OLD DENTON RD STE 111 #307
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City | CARROLLTON
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State | TX
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Zip | 75007-5074
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Country | US
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Telephone | 469-283-0496
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Fax |
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Authorized Official
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Title or Position | PAMS NPI ADMINISTRATOR
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Name | MICHELLE SILVA
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Credential |
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Telephone | 210-598-4287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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