MEDICARE: L & E FIRST ASSISTANTS

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	363AS0400X	Surgical Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0050JR	OTHER	TX	BLUE CROSS BLUE SHIELD GR

General Provider Information

NPI Number	:	1356515746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L & E FIRST ASSISTANTS

Provider Business Mailing Address
First Line	:	7228 WILD VALLEY DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-8154
Country	:	US
Telephone Number	:	972-816-4982
Fax Number	:	214-348-2708

Provider Business Practice Location Address
First Line	:	7228 WILD VALLEY DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-8154
Country	:	US
Telephone Number	:	972-816-4982
Fax Number	:	214-348-2708

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MS. DONNA WARD
Credential	:	CPC
Telephone Number	:	972-562-2595

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	04/16/2008

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Directions to “L & E FIRST ASSISTANTS ” Practice Location

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