Healthcare Provider Details

I. General information

NPI: 1326913484
Provider Name (Legal Business Name): AMERICAN ORTHOPEDICS SURGICAL ASSIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ENTERPRISE BLVD STE 209
GREENVILLE SC
29615-3554
US

IV. Provider business mailing address

1141 N LOOP 1604 E # 105-612
SAN ANTONIO TX
78232-1339
US

V. Phone/Fax

Practice location:
  • Phone: 210-598-4268
  • Fax:
Mailing address:
  • Phone: 210-598-4268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ROXANNA LAROQUE
Title or Position: DIRECTOR, CLIENT RELATIONS
Credential:
Phone: 210-598-4268