Provider Demographics
NPI:1073011375
Name:OMDX ASSIST, PLLC
Entity type:Organization
Organization Name:OMDX ASSIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAMS NPI ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-598-4287
Mailing Address - Street 1:1107 HIGHWAY 1431 # 219
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5006
Mailing Address - Country:US
Mailing Address - Phone:512-717-7833
Mailing Address - Fax:
Practice Address - Street 1:1107 HIGHWAY 1431 # 219
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5006
Practice Address - Country:US
Practice Address - Phone:512-717-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty