MEDICARE: QUALIFIED 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	246ZS0410X	Surgical Technologist		TX

General Provider Information

NPI Number	:	1780876003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALIFIED SURGICAL ASSISTANTS INC.

Provider Business Mailing Address
First Line	:	PO BOX 542256
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77254-2256
Country	:	US
Telephone Number	:	281-450-2360
Fax Number	:

Provider Business Practice Location Address
First Line	:	9494 SOUTHWEST FWY
Second Line	:	SUITE 620
City	:	HOUSTON
State	:	TX
Zip	:	77074-1419
Country	:	US
Telephone Number	:	713-777-4539
Fax Number	:	713-777-4542

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID F SMITH
Credential	:	LSA
Telephone Number	:	281-450-2360

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	07/21/2022

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