Organization
DYNAMIC SURGICAL ASSIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D GORMAN RNFA (OWNER)
(214) 227-2457
Entity
Organization
Contact information
Practice address
5222 BAKER BLVD, IRVING, TX 75039-0001
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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