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General NPI Number Information
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NPI Number | 1659987352
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Entity Type | Organization
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Legal Business Name | TMB SURGICAL ASSTANT
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 5007 FM 1960 RD W # 334
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City | HOUSTON
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State | TX
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Zip | 77069
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Country | US
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Telephone | 713-405-0230
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 681381
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City | HOUSTON
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State | TX
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Zip | 77268
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Country | US
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Telephone | 713-405-0230
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Fax |
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Authorized Official
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Title or Position | CERTIFIED SURGICAL FIRST ASSIST
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Name | MS. TANGELA BRISTO
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Credential | ALLIED HEALTH
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Telephone | 713-405-0230
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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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