Healthcare Provider Details

I. General information

NPI: 1003005539
Provider Name (Legal Business Name): NITYA SURGICAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8038 WURZBACH RD # 650B
SAN ANTONIO TX
78229-3817
US

IV. Provider business mailing address

407 PUEBLO PINTADO
HELOTES TX
78023-4725
US

V. Phone/Fax

Practice location:
  • Phone: 713-464-7555
  • Fax: 713-464-0219
Mailing address:
  • Phone: 713-464-7555
  • Fax: 713-464-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA J WILLIAMS
Title or Position: BILLING MANAGER
Credential:
Phone: 713-464-7555