Provider Demographics
NPI:1205496700
Name:PRIME ASSISTANT SOLUTIONS LLC
Entity type:Organization
Organization Name:PRIME ASSISTANT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ETMINAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-562-4400
Mailing Address - Street 1:PO BOX 540088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-0088
Mailing Address - Country:US
Mailing Address - Phone:713-850-1190
Mailing Address - Fax:
Practice Address - Street 1:12121 WESTHEIMER RD STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6682
Practice Address - Country:US
Practice Address - Phone:832-277-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-17
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty