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NPI Code Detail

MEDICARE: PROFICIO SURGICAL ASSISTANTS, LLC

MEDICARE: PROFICIO SURGICAL ASSISTANTS, 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
1174400000XSpecialist

General Provider Information

NPI Number : 1437557162
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROFICIO SURGICAL ASSISTANTS, LLC
Provider Business Mailing Address
First Line : 3536 HIGHWAY 6 # 150
Second Line :
City : SUGAR LAND
State : TX
Zip : 77478-4401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6544 GREATWOOD PKWY STE A
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-6808
Country : US
Telephone Number : 832-277-0500
Fax Number :
Authorized Official
Title or Position : COO
Name : JAIME OLMO
Credential :
Telephone Number : 832-277-0500
Provider Enumeration Date : 12/11/2014
Last Update Date : 03/11/2024

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Directions to “PROFICIO SURGICAL ASSISTANTS, LLC ” Practice Location

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