Provider Demographics
NPI: | 1114462249 |
---|---|
Name: | WORTH SURGICAL ASSOCIATES, PLLC |
Entity type: | Organization |
Organization Name: | WORTH SURGICAL ASSOCIATES, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BILLING MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCALPIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 214-370-3535 |
Mailing Address - Street 1: | PO BOX 206749 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75320-6749 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-370-3535 |
Mailing Address - Fax: | 214-370-0004 |
Practice Address - Street 1: | 8840 CYPRESS WATERS BLVD |
Practice Address - Street 2: | SUITE 190 |
Practice Address - City: | COPPELL |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75019-4594 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-370-3535 |
Practice Address - Fax: | 214-370-0004 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-12-28 |
Last Update Date: | 2016-12-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |