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NPI Code Detail

MEDICARE: CAND A SURGICAL ASSISTANT SAND CONSULTANTS LLC.

MEDICARE: CAND A SURGICAL ASSISTANT SAND CONSULTANTS 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
1363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1932607074
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAND A SURGICAL ASSISTANT SAND CONSULTANTS LLC.
Provider Business Mailing Address
First Line : 7759 GREENSWARTH LN
Second Line :
City : HOUSTON
State : TX
Zip : 77075-3607
Country : US
Telephone Number : 832-967-4960
Fax Number :
Provider Business Practice Location Address
First Line : 7759 GREENSWARTH LN
Second Line :
City : HOUSTON
State : TX
Zip : 77075-3607
Country : US
Telephone Number : 832-967-4960
Fax Number :
Authorized Official
Title or Position : CERTIFIED SURGICAL ASSISTANT
Name : MR. CHARLES LENFORD HOUSE JR.
Credential : CSA/CST
Telephone Number : 832-967-4960
Provider Enumeration Date : 01/23/2018
Last Update Date : 01/23/2018

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Directions to “CAND A SURGICAL ASSISTANT SAND CONSULTANTS LLC. ” Practice Location

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