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General NPI Number Information
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NPI Number | 1861141582
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Entity Type | Organization
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Legal Business Name | ELITE SURGICAL STAFFING, PLLC
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 11212 STATE HIGHWAY 151
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4498
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Country | US
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Telephone | 405-708-8049
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Fax |
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Provider Business Mailing Address
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Address Line | 14431 PALOMINO PL
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City | SAN ANTONIO
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State | TX
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Zip | 78254-4416
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Country | US
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Telephone | 405-708-8049
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER/RNFA
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Name | MS. KATHLEEN ELLEN GRZYBOWSKI
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Credential | RN
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Telephone | 405-708-8049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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