Provider Demographics
NPI:1447680038
Name:TSA MEDSERVICES, PLLC
Entity type:Organization
Organization Name:TSA MEDSERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-707-0005
Mailing Address - Street 1:2140 EAST SOUTHLAKE BLVD,
Mailing Address - Street 2:SUITE L-696
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:972-707-0005
Mailing Address - Fax:888-992-6199
Practice Address - Street 1:2140 EAST SOUTHLAKE BLVD,
Practice Address - Street 2:SUITE L-696
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:972-707-0005
Practice Address - Fax:888-992-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty