Healthcare Provider Details

I. General information

NPI: 1902358609
Provider Name (Legal Business Name): SALIENT SURGICAL ASSISTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 COVENT DR
KYLE TX
78640-5802
US

IV. Provider business mailing address

5401 S FM 1626 STE # 170-231
KYLE TX
78640
US

V. Phone/Fax

Practice location:
  • Phone: 510-862-6051
  • Fax: 512-262-7456
Mailing address:
  • Phone: 510-862-6051
  • Fax: 512-262-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. HECTOR CHAVEZ
Title or Position: OWNER/ MANAGER
Credential: LSA
Phone: 510-862-6051