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General NPI Number Information
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NPI Number | 1578805594
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Entity Type | Organization
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Legal Business Name | STEELE SURGICAL ASSISTANTS, LLC
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 5556 NEW TERRITORY BLVD APT 9107B
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City | SUGAR LAND
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State | TX
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Zip | 77479-6555
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Country | US
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Telephone | 832-277-8607
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Fax |
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Provider Business Mailing Address
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Address Line | 5556 NEW TERRITORY BLVD APT 9107B
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City | SUGAR LAND
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State | TX
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Zip | 77479-6555
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Country | US
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Telephone | 832-277-8607
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TYLAN J STEELE
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Credential | CSA
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Telephone | 832-277-8607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 3652
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License Number State | TX
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