MEDICARE: LEND A HAND SURGICAL ASSISTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1215273222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEND A HAND SURGICAL ASSISTING LLC

Provider Business Mailing Address
First Line	:	PO BOX 2626
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76113-2626
Country	:	US
Telephone Number	:	817-294-7444
Fax Number	:	817-294-7172

Provider Business Practice Location Address
First Line	:	1545 WEST SOUTHLAKE BLVD
Second Line	:	SUITE 175
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6173
Country	:	US
Telephone Number	:	817-748-8700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIM WESTENRIEDER
Credential	:	CFA
Telephone Number	:	817-294-7444

Provider Enumeration Date	:	12/19/2012
Last Update Date	:	12/19/2012

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