Healthcare Provider Details

I. General information

NPI: 1871733816
Provider Name (Legal Business Name): SKS ASSISTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17515 SPRING CYPRESS RD # C-228
CYPRESS TX
77429-2688
US

IV. Provider business mailing address

17515 SPRING CYPRESS RD # C-228
CYPRESS TX
77429-2688
US

V. Phone/Fax

Practice location:
  • Phone: 281-653-2924
  • Fax: 713-583-5766
Mailing address:
  • Phone: 281-653-2924
  • Fax: 713-583-5766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1563
License Number StateTX

VIII. Authorized Official

Name: SEAN SMITH
Title or Position: OWNER
Credential:
Phone: 281-653-2924