Healthcare Provider Details

I. General information

NPI: 1851794085
Provider Name (Legal Business Name): SCOPE SURGICAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21402 MEADOWHILL DR
SPRING TX
77388-3345
US

IV. Provider business mailing address

21402 MEADOWHILL DR
SPRING TX
77388-3345
US

V. Phone/Fax

Practice location:
  • Phone: 281-642-3808
  • Fax: 281-954-9716
Mailing address:
  • Phone: 281-642-3808
  • Fax: 281-954-9716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SUSAN LYNN HERNDON
Title or Position: LICENSED SURGICAL ASSISTANT
Credential: CSA, LSA
Phone: 281-642-3808