Healthcare Provider Details

I. General information

NPI: 1396172185
Provider Name (Legal Business Name): OPRTHOPAEDIC SURGICAL ASSISTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2013
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7933 FARMINGHAM ROAD SUITE C BOX 11
HUMBLE TX
77346
US

IV. Provider business mailing address

7933 FARMINGHAM RD SUITE C BOX 11
HUMBLE TX
77346-2287
US

V. Phone/Fax

Practice location:
  • Phone: 281-973-9781
  • Fax: 844-409-5532
Mailing address:
  • Phone: 281-973-9781
  • Fax: 844-409-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIC R JAMRICH
Title or Position: OWNER
Credential: MD
Phone: 303-225-8120