Provider Demographics
NPI:1891187167
Name:CONKLIN FIRST ASSIST
Entity Type:Organization
Organization Name:CONKLIN FIRST ASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA,CNOR
Authorized Official - Phone:972-904-6376
Mailing Address - Street 1:1807 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3068
Mailing Address - Country:US
Mailing Address - Phone:972-904-6376
Mailing Address - Fax:
Practice Address - Street 1:1807 BRIARCLIFF DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3068
Practice Address - Country:US
Practice Address - Phone:972-904-6376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX750229282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital