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General NPI Number Information
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NPI Number | 1831729060
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Entity Type | Organization
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Legal Business Name | PRECISION SURGICAL ASSISTANCE LLC
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 3797 PORTLAND DR
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City | RENO
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State | NV
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Zip | 89511-6037
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Country | US
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Telephone | 214-227-2457
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Fax | 214-764-0880
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Provider Business Mailing Address
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Address Line | 3797 PORTLAND DR
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City | RENO
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State | NV
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Zip | 89511-6037
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Country | US
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Telephone | 775-762-8353
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Fax | 214-764-0880
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Authorized Official
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Title or Position | SHAREHOLDER
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Name | VENICIO L LIRAG JR.
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Credential | RNFA
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Telephone | 775-762-8353
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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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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number |
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License Number State |
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