Provider Demographics
NPI:1487802310
Name:ALLIED SURGICAL ASSISTANTS, INC.
Entity type:Organization
Organization Name:ALLIED SURGICAL ASSISTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:T
Authorized Official - Last Name:PHU
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:817-988-8518
Mailing Address - Street 1:PO BOX 1232
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-1232
Mailing Address - Country:US
Mailing Address - Phone:817-988-8518
Mailing Address - Fax:817-753-6171
Practice Address - Street 1:228 TIPPERARY DR
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2536
Practice Address - Country:US
Practice Address - Phone:817-988-8518
Practice Address - Fax:817-753-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664284163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty