MEDICARE: NATIONAL SURGICALSTAFF HEALTH PROFESSIONALS 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	SA00074	TX
2	163WM0705X	Medical-Surgical Registered Nurse
3	363AS0400X	Surgical Physician Assistant	SA00074	TX

General Provider Information

NPI Number	:	1952772535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL SURGICALSTAFF HEALTH PROFESSIONALS LLC

Provider Business Mailing Address
First Line	:	236 MONKEY RD
Second Line	:
City	:	ELGIN
State	:	TX
Zip	:	78621-5506
Country	:	US
Telephone Number	:	432-935-1755
Fax Number	:	512-285-4776

Provider Business Practice Location Address
First Line	:	236 MONKEY RD
Second Line	:
City	:	ELGIN
State	:	TX
Zip	:	78621-5506
Country	:	US
Telephone Number	:	432-935-1755
Fax Number	:	512-285-4776

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEROLD STEPHEN GREER
Credential	:	PHD LSA OPA-C
Telephone Number	:	432-935-1755

Provider Enumeration Date	:	10/08/2015
Last Update Date	:	10/21/2015

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