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General NPI Number Information
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NPI Number | 1750407813
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Entity Type | Organization
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Legal Business Name | INDEPENDENT SURGICAL ASSISTANCE
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 13938 TRIBE DR
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City | CYPRESS
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State | TX
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Zip | 77429-4157
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Country | US
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Telephone | 281-255-9476
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Fax |
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Provider Business Mailing Address
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Address Line | 13938 TRIBE DR
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City | CYPRESS
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State | TX
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Zip | 77429-4157
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Country | US
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Telephone | 281-255-9476
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Fax |
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Authorized Official
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Title or Position | CSA
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Name | MR. FRANCIS A PEREZ
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Credential |
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Telephone | 281-255-9476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | CSA
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License Number State | MD
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