Healthcare Provider Details

I. General information

NPI: 1851804868
Provider Name (Legal Business Name): ASAP SURGICAL ASSISTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 BOSTON ST SUITE J2
BALTIMORE MD
21224
US

IV. Provider business mailing address

1141 N LOOP 1604 E #105-612
SAN ANTONIO TX
78232
US

V. Phone/Fax

Practice location:
  • Phone: 410-844-4530
  • Fax:
Mailing address:
  • Phone: 410-844-4530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ROXANNA LAROQUE
Title or Position: DIRECTOR OF CLIENT EXPERIENCE
Credential:
Phone: 210-598-2801