MEDICARE: PLANO ASSIST, PLLC

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1447728787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANO ASSIST, PLLC

Provider Business Mailing Address
First Line	:	1717 N AKARD ST # 2680
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-2301
Country	:	US
Telephone Number	:	469-283-0196
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 N AKARD # 2680
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-2301
Country	:	US
Telephone Number	:	469-283-0196
Fax Number	:

Authorized Official
Title or Position	:	PAMS NPI ADMINISTRATOR
Name	:	TIM DELONG
Credential	:
Telephone Number	:	210-598-2800

Provider Enumeration Date	:	11/05/2018
Last Update Date	:	11/05/2018

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Directions to “PLANO ASSIST, PLLC ” Practice Location

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