MEDICARE: CHOICE SURGICAL ASSISTANTS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1003084815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOICE SURGICAL ASSISTANTS, INC.

Provider Business Mailing Address
First Line	:	14090 SOUTHWEST FWY STE 300
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3679
Country	:	US
Telephone Number	:	281-340-2090
Fax Number	:

Provider Business Practice Location Address
First Line	:	14090 SOUTHWEST FWY STE 300
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3679
Country	:	US
Telephone Number	:	281-340-2090
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. JEFFREY ALAN KUNZE
Credential	:
Telephone Number	:	281-340-2090

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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