117 Surgical Assistants, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

117 SURGICAL ASSISTANTS, PLLC

Practice address

8840 Cypress Waters Blvd Ste 190
Coppell, TX 75019-4621

Phone

(817) 485-5100

NPI assigned

Jan 18, 2017

Last updated

Jan 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles C Neff

Title

Director

Phone

(817) 485-5100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1760928576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 CYPRESS WATERS BLVD STE 190",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194621",
            "telephone_number": "817-485-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 CYPRESS WATERS BLVD STE 190",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194621",
            "telephone_number": "817-485-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "117 SURGICAL ASSISTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "NEFF",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-485-5100"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Coppell, TX
• Providers in Coppell, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.