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General NPI Number Information
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NPI Number | 1558631457
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Entity Type | Organization
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Legal Business Name | AIDE SURGICAL ASSISTANTS INC
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Dates
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Enumeration Date | 01/09/2012
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 1206 CHRISTINE ST
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City | HOUSTON
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State | TX
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Zip | 77017-4830
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Country | US
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Telephone | 832-455-1729
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4514
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City | PASADENA
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State | TX
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Zip | 77502-0514
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Country | US
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Telephone | 832-455-1729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CYNTHIA MONTELONGO
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Credential | CSA
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Telephone | 832-455-1729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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