Organization
INDEPENDENT FIRST ASSISTANT, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM CASEY FERNANDEZ LSA (CEO, OWNER)
(832) 671-9795
Entity
Organization
Contact information
Practice address
23203 S WATERLAKE DR, RICHMOND, TX 77406-7667
(832) 671-9795
Mailing address
23203 S WATERLAKE DR, RICHMOND, TX 77406-7667
(832) 671-9795
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437427648
NPI TYPE 1 PROVIDER
TX
Enumeration date
11/02/2016
Last updated
02/21/2017
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