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General NPI Number Information
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NPI Number | 1104017193
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Entity Type | Organization
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Legal Business Name | CORE SURGICAL ASSISTANTS
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 2616 S LOOP W SUITE 590
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City | HOUSTON
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State | TX
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Zip | 77054-2662
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Country | US
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Telephone | 832-364-6683
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20127
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City | HOUSTON
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State | TX
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Zip | 77225-0127
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Country | US
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Telephone | 832-364-6683
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANK GREAVES
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Credential |
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Telephone | 832-364-6683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | SA00294
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License Number State | TX
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