Organization
NEW LIFE SURGICAL ASSISTING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTAY LANE PARKER DNP, APRN, WHNP-BC (OWNER)
(682) 500-0928
Entity
Organization
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 508-0710
Mailing address
700 SMITH ST # 61070, SMB 6713, HOUSTON, TX 77002-2714
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356408001
—
TX
Enumeration date
06/28/2019
Last updated
06/28/2019
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