Healthcare Provider Details

I. General information

NPI: 1780826842
Provider Name (Legal Business Name): DMT SURGICAL ASSISTANT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20935 SOUTH AMBER TRAIL
CYPRESS TX
77433-6041
US

IV. Provider business mailing address

PO BOX 1062
CYPRESS TX
77410-1062
US

V. Phone/Fax

Practice location:
  • Phone: 281-460-8771
  • Fax: 281-256-9416
Mailing address:
  • Phone: 281-460-8771
  • Fax: 281-256-9416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: JULIO DUARTE
Title or Position: OWNER
Credential: LSA
Phone: 281-460-8771