Healthcare Provider Details

I. General information

NPI: 1770983470
Provider Name (Legal Business Name): FIRST ASSISTANTS SAN ANTONIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2014
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 MITCH THOMAS
PLEASANTON TX
78064-4827
US

IV. Provider business mailing address

941 MITCH THOMAS
PLEASANTON TX
78064-4827
US

V. Phone/Fax

Practice location:
  • Phone: 210-863-8127
  • Fax: 281-974-3171
Mailing address:
  • Phone: 210-863-8127
  • Fax: 281-974-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROGER GUARDIOLA JR.
Title or Position: OWNER
Credential: CSFA
Phone: 210-863-8127