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General NPI Number Information
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NPI Number | 1154737591
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Entity Type | Organization
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Legal Business Name | ELITE SURGICAL ASSISTANTS
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 1422 ROANWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77090-2420
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Country | US
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Telephone | 832-453-1856
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Fax | 855-405-5959
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Provider Business Mailing Address
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Address Line | 1422 ROANWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77090-2420
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Country | US
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Telephone | 832-453-1856
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Fax | 855-405-5959
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Authorized Official
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Title or Position | LICENSED SURGICAL FIRST ASSISTANT
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Name | MR. ROGER ZAMARRON
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Credential |
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Telephone | 832-453-1856
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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 | SA00056
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA00056
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License Number State | TX
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