Organization
FORT WORTH FIRST ASSIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TOBIAS GRAY (PRESIDENT)
(615) 345-5510
Entity
Organization
Contact information
Practice address
214 CENTERVIEW DR, SUITE 100, BRENTWOOD, TN 37027-5274
(615) 345-5510
Mailing address
214 CENTERVIEW DR, SUITE 100, BRENTWOOD, TN 37027-5274
(615) 345-5510
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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