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Organization

TEXAS INDEPENDENT FIRST ASSIST

Active
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Organization

TEXAS INDEPENDENT FIRST ASSIST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA MAUREEN MANTLE LSA (OWNER)
(214) 227-2457
Entity
Organization

Contact information

Practice address
1901 FM 718, AURORA, TX 76078-5213
(940) 206-1069
Mailing address
PO BOX 129, RHOME, TX 76078-0129
(214) 227-2457
(214) 764-0880

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
04/05/2022
Last updated
05/22/2026
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