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General NPI Number Information
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NPI Number | 1669968954
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Entity Type | Organization
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Legal Business Name | UNITED SURGICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 101 PARK AVE STE 1300
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City | OKLAHOMA CITY
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State | OK
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Zip | 73102-7216
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Country | US
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Telephone | 210-598-4262
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 N LOOP 1604 E #105-612
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City | SAN ANTONIO
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State | TX
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Zip | 78232
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Country | US
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Telephone | 210-598-4262
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLIENT EXPERIENCE
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Name | ROXANNA LAROQUE
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Credential |
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Telephone | 210-598-4262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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