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General NPI Number Information
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NPI Number | 1679232912
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Entity Type | Organization
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Legal Business Name | LEADING SURGICAL ASSISTANTS LLC
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 8726 CEDARDALE DR
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City | HOUSTON
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State | TX
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Zip | 77055-4809
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Country | US
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Telephone | 713-254-4567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19762
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City | HOUSTON
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State | TX
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Zip | 77224-9762
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. JOSE CHAPA
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Credential |
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Telephone | 137-254-4567
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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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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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