MEDICARE: ACE SURGICAL ASSISTANT ASSOCIATES LLC

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	246ZC0007X	Surgical Assistant
2	363AS0400X	Surgical Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA00279	OTHER	TX	LICENSE SURGICAL ASSISTATN

General Provider Information

NPI Number	:	1427514207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE SURGICAL ASSISTANT ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	14403 WALTERS RD. #680366
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-0366
Country	:	US
Telephone Number	:	713-254-6136
Fax Number	:	281-893-0780

Provider Business Practice Location Address
First Line	:	14403 WALTERS RD # 680366
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1336
Country	:	US
Telephone Number	:	281-653-2924
Fax Number	:	832-478-9266

Authorized Official
Title or Position	:	OWNER
Name	:	CATALINO PITTY
Credential	:	MD, LSA
Telephone Number	:	281-653-2924

Provider Enumeration Date	:	02/16/2019
Last Update Date	:	05/15/2021

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