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General NPI Number Information
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NPI Number | 1801147681
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Entity Type | Organization
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Legal Business Name | PARNELL SURGICAL ASSISTING, LLC
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 2313 PARKHAVEN DRIVE
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City | PLANO
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State | TX
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Zip | 75075-2014
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Country | US
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Telephone | 972-768-7337
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Fax | 972-202-0408
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Provider Business Mailing Address
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Address Line | 2313 PARKHAVEN DRIVE
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City | PLANO
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State | TX
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Zip | 75075-2014
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Country | US
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Telephone | 972-768-7337
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Fax | 972-202-0408
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMANTHA M. PARNELL
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Credential | PA-C
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Telephone | 972-768-7337
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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 | PA04153
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License Number State | TX
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