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General NPI Number Information
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NPI Number | 1235424433
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Entity Type | Organization
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Legal Business Name | SURGEONS CHOICE SURGICAL FIRST ASSISTANT
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 1000 GLENCREST DR
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City | CEDAR HILL
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State | TX
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Zip | 75104-2926
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Country | US
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Telephone | 214-378-9898
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Fax | 214-378-9888
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Provider Business Mailing Address
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Address Line | 1000 GLENCREST DR
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City | CEDAR HILL
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State | TX
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Zip | 75104-2926
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Country | US
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Telephone | 214-378-9898
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Fax | 214-378-9888
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGELA JONES
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Credential | CPC
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Telephone | 214-378-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 577126
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License Number State | TX
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