Basic Information
| Provider Information | |||||||||
| NPI: | 1104557305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MI PHYSICIAN ASSISTANT SERVICES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 960 RIDGEVIEW DR STE 140-284 | ||||||||
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| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750135542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143907697 | ||||||||
| FaxNumber: | 9724326692 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 E TAYLOR ST STE 308 | ||||||||
| Address2: | |||||||||
| City: | SHERMAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750902826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143907697 | ||||||||
| FaxNumber: | 9724326692 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2022 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| AuthorizedOfficialLastName: | SHAIKH | ||||||||
| AuthorizedOfficialFirstName: | ADNAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 2143907697 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.