MEDICARE: ARTHUR SURGICAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1063982262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHUR SURGICAL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2166
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77487-2166
Country	:	US
Telephone Number	:	832-875-4469
Fax Number	:

Provider Business Practice Location Address
First Line	:	17007 IRISH OAKS CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5884
Country	:	US
Telephone Number	:	832-875-4469
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUCIO O ZALDANA
Credential	:	LSA
Telephone Number	:	832-875-4469

Provider Enumeration Date	:	11/29/2018
Last Update Date	:	11/29/2018

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