Provider Demographics
NPI:1245714914
Name:ELITE EXAMINER'S LLC
Entity type:Organization
Organization Name:ELITE EXAMINER'S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NISHI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-DICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BABS HR
Authorized Official - Phone:214-554-0595
Mailing Address - Street 1:7210 CASCADE CT APT 817
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-7406
Mailing Address - Country:US
Mailing Address - Phone:214-554-0595
Mailing Address - Fax:817-900-7219
Practice Address - Street 1:7210 CASCADE CT APT 817
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-7406
Practice Address - Country:US
Practice Address - Phone:214-554-0595
Practice Address - Fax:817-900-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service