Provider Demographics
NPI:1114305794
Name:RUSSELL ASSISTING
Entity Type:Organization
Organization Name:RUSSELL ASSISTING
Other - Org Name:TIMI RUSSELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:713-705-7953
Mailing Address - Street 1:2430 FAWNLAKE CIR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493
Mailing Address - Country:US
Mailing Address - Phone:713-705-7953
Mailing Address - Fax:
Practice Address - Street 1:2430 FAWNLAKE CIR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493
Practice Address - Country:US
Practice Address - Phone:713-705-7953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty