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General NPI Number Information
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NPI Number | 1841749181
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Entity Type | Organization
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Legal Business Name | TSUNAMI ASSISTING CONSULTANTS, LLC
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 3029 BIGLEAF DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-6601
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Country | US
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Telephone | 469-855-7210
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Fax |
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Provider Business Mailing Address
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Address Line | 3029 BIGLEAF DR
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City | LITTLE ELM
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State | TX
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Zip | 75068-6601
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Country | US
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Telephone | 469-855-7210
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHARLES ANDERSON TAYLOR III
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Credential |
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Telephone | 469-855-7210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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Taxonomy #2
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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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