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NPI 1881592632

NPI 1881592632 : STELLAR SURGICAL ASSISTING : JUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1881592632
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    Entity Type          |    Organization 
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    Legal Business Name  |    STELLAR SURGICAL ASSISTING 
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Dates
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    Enumeration Date     |    10/29/2026
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    Last Update Date     |    10/30/2026
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Provider Practice Location Address
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    Address Line         |    609 SPAULDING ST 
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    City                 |    JUSTIN
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    State                |    TX
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    Zip                  |    76247-2350
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    Country              |    US
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    Telephone            |    214-736-8738
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    Fax                  |    214-764-0880
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2550 
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    City                 |    ROWLETT
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    State                |    TX
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    Zip                  |    75030-2550
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    Country              |    US
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    Telephone            |    214-736-8738
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    Fax                  |    214-764-0880
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MAKAYLA  LACKEY 
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    Credential           |    
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    Telephone            |    214-736-8738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    246ZC0007X
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    Taxonomy Name        |    Surgical Assistant
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    License Number       |    
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    License Number State |    
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