Provider Demographics
NPI:1316222425
Name:DALLAS SURGICAL ASSISTANCE
Entity Type:Organization
Organization Name:DALLAS SURGICAL ASSISTANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIMLAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-550-5300
Mailing Address - Street 1:PO BOX 670531
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75367-0531
Mailing Address - Country:US
Mailing Address - Phone:214-550-5300
Mailing Address - Fax:214-618-7733
Practice Address - Street 1:5566 W MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3669
Practice Address - Country:US
Practice Address - Phone:214-550-5300
Practice Address - Fax:214-618-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX694424163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty