Provider Demographics
NPI:1346530086
Name:PERKINS 1ST ASSISTANTS LLC
Entity Type:Organization
Organization Name:PERKINS 1ST ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:214-733-2789
Mailing Address - Street 1:3245 W MAIN ST
Mailing Address - Street 2:STE 235-182
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4411
Mailing Address - Country:US
Mailing Address - Phone:214-733-2789
Mailing Address - Fax:
Practice Address - Street 1:3245 W MAIN ST
Practice Address - Street 2:STE 235-182
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4411
Practice Address - Country:US
Practice Address - Phone:214-733-2789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00349363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty