NPIMap

Organization Active NPI

Ultimate Surgical Assisting

  • Surgical Physician Assistant
  • Dallas, TX
National Provider Identifier
1679727259
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
667351 Issued in TX
Legal business name
ULTIMATE SURGICAL ASSISTING
Practice address
1151 N Buckner Blvd
Suite 308
Dallas, TX 75218-3426
Phone
(972) 270-4800
Fax
(214) 367-1153
NPI assigned
Nov 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Authorized official

Name
Dana Diane Lackey
Title
Office Manager
Phone
(972) 270-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 667351 TX Primary

Addresses

Primary practice location

1151 N Buckner Blvd
Suite 308
Dallas, TX 75218-3426

Mailing address

1151 N Buckner Blvd
Suite 308
Dallas, TX 75218-3426
Phone (972) 270-4800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1679727259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 N BUCKNER BLVD",
            "address_2": "SUITE 308",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183426",
            "telephone_number": "972-270-4800",
            "fax_number": "214-367-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 N BUCKNER BLVD",
            "address_2": "SUITE 308",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183426",
            "telephone_number": "972-270-4800",
            "fax_number": "214-367-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE SURGICAL ASSISTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-10",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-270-4800"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "667351",
            "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 Nov 10, 2008; 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.