Basic Information
| Provider Information | |||||||||
| NPI: | 1215273222 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEND A HAND SURGICAL ASSISTING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2626 | ||||||||
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| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761132626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172947444 | ||||||||
| FaxNumber: | 8172947172 | ||||||||
| Practice Location | |||||||||
| Address1: | 1545 WEST SOUTHLAKE BLVD | ||||||||
| Address2: | SUITE 175 | ||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760926173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177488700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2012 | ||||||||
| LastUpdateDate: | 12/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | WESTENRIEDER | ||||||||
| AuthorizedOfficialFirstName: | KIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8172947444 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CFA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | Y | 193400000X SINGLE SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.