Organization
ROBOTIC AND SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA J. OLSON PA-C (MANAGING PARTNER)
(682) 738-8079
Entity
Organization
Contact information
Practice address
2313 PARKHAVEN DRIVE, PLANO, TX 75075-2014
(682) 738-8079
(682) 738-8079
Mailing address
2313 PARKHAVEN DRIVE, PLANO, TX 75075-2014
(682) 738-8079
(682) 738-8079
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
631427
TX
363AS0400X
Surgical Physician Assistant
Primary
PA00025
TX
363AS0400X
Surgical Physician Assistant
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3256273
—
TX
01
—
DU0666
RAILROAD MEDICARE
TX
Enumeration date
07/31/2012
Last updated
03/28/2017
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