Healthcare Provider Details

I. General information

NPI: 1285906982
Provider Name (Legal Business Name): PRO SURGICAL ASSISTING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 LOCHMOOR LN
PEARLAND TX
77581-6716
US

IV. Provider business mailing address

1115 LOCHMOOR LN
PEARLAND TX
77581-6716
US

V. Phone/Fax

Practice location:
  • Phone: 713-560-1690
  • Fax:
Mailing address:
  • Phone: 713-560-1690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number114433
License Number StateTX

VIII. Authorized Official

Name: CHRISTOPER LEE CRAIG
Title or Position: CERTIFIED SURGICAL FIRST ASSIST
Credential:
Phone: 713-560-1690