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Organization

QUALITY ASSIST, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENDALL M POLK LSA,CSFA (LSA,CSFA)
(214) 927-6539
Entity
Organization

Contact information

Practice address
205 CRENSHAW DR, MANSFIELD, TX 76063-3451
(214) 927-6539
(817) 394-1231
Mailing address
3540 E. BRAOD ST. STE 102, PMB 237, MANSFIELD, TX 76063

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
246ZX2200X
Orthopedic Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1285009803
NPI
Enumeration date
01/28/2016
Last updated
06/16/2018
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