Organization
DEEP BLUE FIRST ASSIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CECE PANNELL (OFF MGR)
(817) 294-7444
Entity
Organization
Contact information
Practice address
801 W I-20, ARLINGTON, TX 76017-5851
(817) 472-3675
Mailing address
PO BOX 2626, FORT WORTH, TX 76113-2626
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
530175
TX
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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