Healthcare Provider Details

I. General information

NPI: 1255692018
Provider Name (Legal Business Name): SUGAR LAND SURGICAL ASSISTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16605 SOUTHWEST FWY SUITE 285
SUGAR LAND TX
77479-3501
US

IV. Provider business mailing address

16605 SOUTHWEST FWY SUITE 285
SUGAR LAND TX
77479-3501
US

V. Phone/Fax

Practice location:
  • Phone: 281-313-0031
  • Fax: 281-313-0032
Mailing address:
  • Phone: 281-313-0031
  • Fax: 281-313-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number654315
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number807047
License Number StateTX

VIII. Authorized Official

Name: DR. RAJESH BINDAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-313-0031