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General NPI Number Information
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NPI Number | 1659904159
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Entity Type | Organization
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Legal Business Name | CJA SURGICAL ASSISTANTS
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 13702 FRENCH OAKS
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City | HELOTES
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State | TX
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Zip | 78023-4582
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Provider Business Mailing Address
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Address Line | 13702 FRENCH OAKS
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City | HELOTES
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State | TX
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Zip | 78023-4582
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA MARTINEZ
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Credential | SA-C
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Telephone | 214-227-2457
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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 |
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License Number State |
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