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General NPI Number Information
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NPI Number | 1770956229
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Entity Type | Organization
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Legal Business Name | SURGICAL ELITE PLLC
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 7505 BEACON HILL RD
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City | MCKINNEY
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State | TX
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Zip | 75070-2752
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Country | US
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Telephone | 716-583-2719
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Fax |
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Provider Business Mailing Address
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Address Line | 7505 BEACON HILL RD
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City | MCKINNEY
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State | TX
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Zip | 75070-2752
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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 | CEO
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Name | JULIANNE SANTAROSA
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Credential | M.D.
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Telephone | 716-583-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P2062
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License Number State | TX
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