Organization
DFW LICENSED ASSISTANT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAEGAN SHEPHERD CSFA (OWNER/DIRECTOR)
(817) 851-5517
Entity
Organization
Contact information
Practice address
4 ROCKLAND CT, MANSFIELD, TX 76063-5006
(817) 851-5517
(817) 756-7672
Mailing address
4 ROCKLAND CT, MANSFIELD, TX 76063-5006
(817) 851-5517
(817) 756-7672
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
132517
TX
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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