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General NPI Number Information
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NPI Number | 1891869616
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Entity Type | Organization
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Legal Business Name | ALTABO FIRST ASSIST
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 3947 STOCKTON LN
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City | DALLAS
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State | TX
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Zip | 75287-4921
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Country | US
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Telephone | 214-912-9931
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Fax | 972-862-2507
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Provider Business Mailing Address
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Address Line | 3947 STOCKTON LN
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City | DALLAS
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State | TX
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Zip | 75287-4921
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Country | US
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Telephone | 214-912-9931
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Fax | 972-862-2507
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Authorized Official
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Title or Position | PRESIDENT
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Name | BEVERLY JOAN BOHAN
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Credential | RNFA
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Telephone | 214-912-9931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN451277
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License Number State |
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