Provider Demographics
NPI:1255639316
Name:ASMO OVERHEAD, LLP
Entity type:Organization
Organization Name:ASMO OVERHEAD, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-698-3865
Mailing Address - Street 1:2074 ANTILLEY RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5209
Mailing Address - Country:US
Mailing Address - Phone:325-698-3865
Mailing Address - Fax:
Practice Address - Street 1:2074 ANTILLEY RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5209
Practice Address - Country:US
Practice Address - Phone:325-698-3865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty