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General NPI Number Information
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NPI Number | 1831663228
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Entity Type | Organization
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Legal Business Name | STAT SURGICAL ASSISTS, PLLC
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 16020 PARK VALLEY DR
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City | ROUND ROCK
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State | TX
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Zip | 78681
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Country | US
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Telephone | 512-629-4329
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Fax |
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Provider Business Mailing Address
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Address Line | MSC 708 PO BOX 4914
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City | HOUSTON
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State | TX
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Zip | 77210-4914
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Country | US
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Telephone | 512-629-4329
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Fax |
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Authorized Official
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Title or Position | LEGAL OPERATIONS MANAGER
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Name | FELICIA ALDERTE
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Credential |
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Telephone | 210-598-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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