NPIMap

Organization Active NPI

Surgical Assistants of Dallas Supplies, LLC

  • Surgical Physician Assistant
  • Dallas, TX
National Provider Identifier
1255596086
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
SURGICAL ASSISTANTS OF DALLAS SUPPLIES, LLC
Practice address
10140 Estate LN
Dallas, TX 75238-2135
Phone
(972) 672-8468
Fax
(214) 221-0614
NPI assigned
Jul 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Ms. Kelly Campbell, PA-C
Title
Partner
Phone
(972) 672-8468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

10140 Estate LN
Dallas, TX 75238-2135

Mailing address

10140 Estate LN
Dallas, TX 75238-2135
Phone (972) 672-8468

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1255596086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 ESTATE LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382135",
            "telephone_number": "972-672-8468",
            "fax_number": "214-221-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10140 ESTATE LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382135",
            "telephone_number": "972-672-8468",
            "fax_number": "214-221-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSISTANTS OF DALLAS SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "972-672-8468",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.