Healthcare Provider Details

I. General information

NPI: 1235693854
Provider Name (Legal Business Name): AMERICAN SURGICAL TRADING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9831 VICKIE LN
FRISCO TX
75035-2501
US

IV. Provider business mailing address

9831 VICKIE LN
FRISCO TX
75035-2501
US

V. Phone/Fax

Practice location:
  • Phone: 469-235-3173
  • Fax:
Mailing address:
  • Phone: 469-235-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. PRINCE V SAMUEL
Title or Position: MANAGER
Credential:
Phone: 469-235-3173