Organization Active NPI

Mdassistllc

  • Anesthesiologist Assistant
  • Waxahachie, TX
National Provider Identifier
1538486246
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Legal business name
MDASSISTLLC
Practice address
1626 W Highway 287 Business
107
Waxahachie, TX 75165-4712
Phone
(972) 937-7240
Fax
(972) 937-4255
NPI assigned
Apr 21, 2010
Last updated
Apr 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Tom Ellis
Title
President
Phone
(972) 937-7240

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU
Anesthesiologist Assistant 367H00000X NU Primary

Addresses

Primary practice location

1626 W Highway 287 Business
107
Waxahachie, TX 75165-4712

Mailing address

1626 W Highway 287 Business
107
Waxahachie, TX 75165-4712
Phone (972) 937-7240

National Provider Directory

National Provider Directory

Locations

1626 W Highway 287 Business
Ste 107
Waxahachie, TX 75165
Phone (972) 937-7240

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1538486246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 W HIGHWAY 287 BUSINESS",
            "address_2": "107",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654712",
            "telephone_number": "972-937-7240",
            "fax_number": "972-937-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 W HIGHWAY 287 BUSINESS",
            "address_2": "107",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751654712",
            "telephone_number": "972-937-7240",
            "fax_number": "972-937-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDASSISTLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-937-7240"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.