Provider Demographics
NPI:1003700246
Name:LONGHORN ASSIST PLLC
Entity type:Organization
Organization Name:LONGHORN ASSIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BOOHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:682-231-2366
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76101-0187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5005 DEERWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-3744
Practice Address - Country:US
Practice Address - Phone:817-676-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty