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General NPI Number Information
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NPI Number | 1861630329
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Entity Type | Organization
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Legal Business Name | LM SURGI-CALL, SURGICAL ASSISTANCE, LLC
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 2718 DURHAM CHASE LN
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City | KATY
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State | TX
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Zip | 77449-4739
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Country | US
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Telephone | 281-829-5417
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Fax | 281-829-5417
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Provider Business Mailing Address
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Address Line | 2718 DURHAM CHASE LN
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City | KATY
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State | TX
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Zip | 77449-4739
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Country | US
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Telephone | 281-829-5417
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Fax | 281-829-5417
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Authorized Official
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Title or Position | LICENSED SURGICAL ASSISTANT
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Name | MRS. LILIANA C. MANZANO
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Credential | L.S.A.
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Telephone | 281-829-5417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | SA00301
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License Number State | TX
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