NPIMap

Organization Active NPI

DFW Licensed Assistant, LLC

  • Surgical Assistant
  • Mansfield, TX
National Provider Identifier
1295271682
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
132517 Issued in TX
Legal business name
DFW LICENSED ASSISTANT, LLC
Practice address
4 Rockland CT
Mansfield, TX 76063-5006
Phone
(817) 851-5517
Fax
(817) 756-7672
NPI assigned
Jan 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Authorized official

Name
Mrs. Maegan Shepherd, CSFA
Title
Owner/Director
Phone
(817) 851-5517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 246ZC0007X 132517 TX Primary

Addresses

Primary practice location

4 Rockland CT
Mansfield, TX 76063-5006

Mailing address

4 Rockland CT
Mansfield, TX 76063-5006
Phone (817) 851-5517

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1295271682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ROCKLAND CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635006",
            "telephone_number": "817-851-5517",
            "fax_number": "817-756-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ROCKLAND CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635006",
            "telephone_number": "817-851-5517",
            "fax_number": "817-756-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFW LICENSED ASSISTANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "MAEGAN",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "817-851-5517",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "132517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.