Healthcare Provider Details

I. General information

NPI: 1447898077
Provider Name (Legal Business Name): MO'S SURGICAL ASSISTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21214 NORTHWEST FWY
CYPRESS TX
77429-3373
US

IV. Provider business mailing address

745 OAKLAND HILLS CIR APT 111
LAKE MARY FL
32746-5847
US

V. Phone/Fax

Practice location:
  • Phone: 832-977-4507
  • Fax:
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