Healthcare Provider Details

I. General information

NPI: 1982189643
Provider Name (Legal Business Name): SURGICAL SUPPORT ALLIANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8210 WALNUT HILL LN STE 130
DALLAS TX
75231-4418
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: 210-598-4262
  • Fax:
Mailing address:
  • Phone: 210-598-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: ROBERT SCHEINBERG
Title or Position: MANAGER
Credential:
Phone: 800-785-8765