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General NPI Number Information
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NPI Number | 1699164913
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Entity Type | Organization
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Legal Business Name | APPLE SURGICAL ASSISTS, LLC
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 5729 LEBANON RD SUITE 144 PMB#333
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City | FRISCO
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State | TX
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Zip | 75034-7260
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Country | US
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Telephone | 469-304-3501
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Fax |
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Provider Business Mailing Address
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Address Line | 5729 LEBANON RD SUITE 144 PMB#333
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City | FRISCO
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State | TX
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Zip | 75034-7260
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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 | ROBERT E BERRY
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Credential | DO
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Telephone | 469-304-3501
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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 | 1135
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License Number State | TX
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