# MDASSISTLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538486246
- **Authorized official:** TOM ELLIS (PRESIDENT)
- **Authorized official phone:** (972) 937-7240

## Contact information

- **Practice address:** 1626 W HIGHWAY 287 BUSINESS, 107, WAXAHACHIE, TX 75165-4712
- **Practice address phone:** (972) 937-7240
- **Practice address fax:** (972) 937-4255
- **Mailing address:** 1626 W HIGHWAY 287 BUSINESS, 107, WAXAHACHIE, TX 75165-4712
- **Mailing address phone:** (972) 937-7240
- **Mailing address fax:** (972) 937-4255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 367H00000X | Anesthesiologist Assistant | — | NULL | Yes |
| 367H00000X | Anesthesiologist Assistant | — | — | Yes |

## Other

- **Enumeration date:** 04/21/2010
- **Last updated:** 04/21/2010