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General NPI Number Information
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NPI Number | 1730534611
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Entity Type | Organization
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Legal Business Name | SMT SURGICAL ASSISTING LLC
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 3139 SUMMERLAND DR
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City | MANVEL
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State | TX
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Zip | 77578-3186
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Country | US
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Telephone | 713-725-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3139 SUMMERLAND DR
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City | MANVEL
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State | TX
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Zip | 77578-3186
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Country | US
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Telephone | 713-725-5000
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Fax |
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | SHANNON M THOMAS
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Credential | LSA
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Telephone | 769-237-9441
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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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