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General NPI Number Information
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NPI Number | 1649781147
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Entity Type | Organization
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Legal Business Name | DIRECT SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 5150 BROADWAY ST
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City | SAN ANTONIO
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State | TX
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Zip | 78209-5710
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Country | US
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Telephone | 520-323-8732
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Fax |
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Provider Business Mailing Address
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Address Line | 6339 E SPEEDWAY BLVD
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City | TUCSON
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State | AZ
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Zip | 85710-1147
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Country | US
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Telephone | 520-323-8732
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Fax |
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Authorized Official
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Title or Position | LEAD PATIENT ADVOCATE
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Name | AUTUMN ROMO
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Credential |
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Telephone | 520-258-0307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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