Healthcare Provider Details

I. General information

NPI: 1558592329
Provider Name (Legal Business Name): BEXAR SURGICAL ASSISTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6923 W LOOP 1604 N STE 206
SAN ANTONIO TX
78254-2545
US

IV. Provider business mailing address

902 ROLLING GRV
SAN ANTONIO TX
78253-5759
US

V. Phone/Fax

Practice location:
  • Phone: 210-560-2369
  • Fax: 210-560-2362
Mailing address:
  • Phone: 210-315-1172
  • Fax: 111-111-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number00338
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLEN HARRIS
Title or Position: OWNER
Credential:
Phone: 210-560-2369