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General NPI Number Information
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NPI Number | 1497165021
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSIST, LLC
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 5005 W ROYAL LN STE 196
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City | IRVING
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State | TX
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Zip | 75063-1959
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Country | US
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Telephone | 817-485-5100
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 650444 DEPT 114
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City | DALLAS
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State | TX
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Zip | 75265-0444
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Country | US
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Telephone | 817-485-5100
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHARLES C NEFF
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Credential |
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Telephone | 817-485-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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