Healthcare Provider Details

I. General information

NPI: 1679953525
Provider Name (Legal Business Name): NB SURGICAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 FAUST LN
HOUSTON TX
77024-4701
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: 800-785-8765
  • Fax: 281-820-1901
Mailing address:
  • Phone: 855-598-2800
  • 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: NEIL BADLANI
Title or Position: MBR
Credential: M.D.
Phone: 724-712-8343