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General NPI Number Information
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NPI Number | 1780202499
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Entity Type | Organization
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Legal Business Name | ALLIANCE HAND AND WRIST SURGERY
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1668 KELLER PKWY STE 300
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City | KELLER
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State | TX
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Zip | 76248-3710
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Country | US
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Telephone | 267-408-9036
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Fax |
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Provider Business Mailing Address
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Address Line | 2140 E SOUTHLAKE BLVD STE L-605
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6516
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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 | PHYSICIAN/MANAGER
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Name | SHUSHAN JACOB
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Credential |
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Telephone | 267-408-9036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number |
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License Number State |
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