Provider Demographics
NPI:1497087357
Name:PROASSIST SURGICAL ASSOCIATE
Entity Type:Organization
Organization Name:PROASSIST SURGICAL ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL FIRST ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:ONICHAMAKA
Authorized Official - Middle Name:LSABELLA
Authorized Official - Last Name:OJIRIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-536-7913
Mailing Address - Street 1:7801 ALMA DR STE 105
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3483
Mailing Address - Country:US
Mailing Address - Phone:214-714-7010
Mailing Address - Fax:
Practice Address - Street 1:7801 ALMA DR STE 105
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3483
Practice Address - Country:US
Practice Address - Phone:214-714-7010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX246ZS0400XOtherTECHNOLOGIST & SURGICAL