Vidasure LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

VIDASURE LLC

Practice address

3245 W Main St
Ste 235-142
Frisco, TX 75034-4411

Phone

(214) 253-9397

NPI assigned

Mar 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Millicent Davis, LCSW

Title

Ceo

Phone

(214) 253-9397

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1144595703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 W MAIN ST",
            "address_2": "STE 235-142",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 W MAIN ST",
            "address_2": "STE 235-142",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344411",
            "telephone_number": "214-253-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDASURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MILLICENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-253-9397",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.