Healthcare Provider Details

I. General information

NPI: 1427690296
Provider Name (Legal Business Name): CHOICE SURGICAL ASSISTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21216 NORTHWEST FWY STE 250
CYPRESS TX
77429-4778
US

IV. Provider business mailing address

PO BOX 953908
LAKE MARY FL
32795-3908
US

V. Phone/Fax

Practice location:
  • Phone: 713-426-2400
  • Fax: 713-426-3204
Mailing address:
  • Phone: 407-302-0089
  • Fax: 407-807-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA BURFORD
Title or Position: BILLING MANAGER
Credential:
Phone: 407-302-0089