MEDICARE: MEGA SURGICAL ASSISTANTS 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	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1740772318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGA SURGICAL ASSISTANTS LLC

Provider Business Mailing Address
First Line	:	8402 VINETREE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4537
Country	:	US
Telephone Number	:	254-458-7855
Fax Number	:

Provider Business Practice Location Address
First Line	:	8402 VINETREE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4537
Country	:	US
Telephone Number	:	254-458-7855
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	KOJO ASARE
Credential	:	CSFA
Telephone Number	:	254-458-7855

Provider Enumeration Date	:	05/30/2018
Last Update Date	:	05/30/2018

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