MEDICARE: PRECISION ASSISTANCE OF SURGERY

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	284300000X	Special Hospital

General Provider Information

NPI Number	:	1295026060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION ASSISTANCE OF SURGERY

Provider Business Mailing Address
First Line	:	PO BOX 591328
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-0116
Country	:	US
Telephone Number	:	210-254-7993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1234 SONESTA LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78260-2462
Country	:	US
Telephone Number	:	210-254-7993
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. RALPH STALEY JR.
Credential	:	CSFA
Telephone Number	:	210-254-7993

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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