Provider Demographics
NPI:1861748592
Name:ORTHOPEDIC ASSIST, LLC
Entity type:Organization
Organization Name:ORTHOPEDIC ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NOONAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-647-7720
Mailing Address - Street 1:19770 KINGSLAND BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1031
Mailing Address - Country:US
Mailing Address - Phone:281-647-7720
Mailing Address - Fax:281-647-7721
Practice Address - Street 1:19770 KINGSLAND BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1031
Practice Address - Country:US
Practice Address - Phone:281-647-7720
Practice Address - Fax:281-647-7721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty