NPIMap

Organization Active NPI

Agile Surgical Assistants, LLC

  • Surgical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1366976235
Registry record updated Apr 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
AGILE SURGICAL ASSISTANTS, LLC
Practice address
8428 Whippoorwill Dr
Fort Worth, TX 76123-1996
Phone
(817) 713-8905
Fax
(817) 394-1427
NPI assigned
Apr 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2017

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

Authorized official

Name
Sergio Giles, LSANPI 1629351150
Title
Chairman/Ceo
Phone
(817) 713-8905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 246ZC0007X SA00564 TX
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

8428 Whippoorwill Dr
Fort Worth, TX 76123-1996

Mailing address

8428 Whippoorwill Dr
Fort Worth, TX 76123-1996
Phone (817) 713-8905

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493424000000",
    "number": "1366976235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8428 WHIPPOORWILL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231996",
            "telephone_number": "817-713-8905",
            "fax_number": "817-394-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8428 WHIPPOORWILL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231996",
            "telephone_number": "817-713-8905",
            "fax_number": "817-394-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGILE SURGICAL ASSISTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-29",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "CHAIRMAN/CEO",
        "authorized_official_telephone_number": "817-713-8905",
        "authorized_official_credential": "LSA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00564",
            "primary": false
        },
        {
            "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 Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.