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General NPI Number Information
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NPI Number | 1821597154
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Entity Type | Organization
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Legal Business Name | WILTIN SURGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 7777 FOREST LN
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1903 LORRAINE AVE
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City | ALLEN
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State | TX
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Zip | 75002-2619
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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 | CEO
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Name | KAREN L WILTIN
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Credential | PA-C
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Telephone | 303-330-8994
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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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