Provider Demographics
NPI:1811350556
Name:DALLAS ELITE TAS SERVICES
Entity type:Organization
Organization Name:DALLAS ELITE TAS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SHOSHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR-HOLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW-IPR
Authorized Official - Phone:214-207-9117
Mailing Address - Street 1:1029 JOHNSON CITY AVE
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5077
Mailing Address - Country:US
Mailing Address - Phone:214-207-9117
Mailing Address - Fax:972-552-5232
Practice Address - Street 1:1029 JOHNSON CITY AVE
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-5077
Practice Address - Country:US
Practice Address - Phone:214-207-9117
Practice Address - Fax:972-552-5232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage