Provider Demographics
NPI:1003005539
Name:NITYA SURGICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:NITYA SURGICAL ASSOCIATES PLLC
Other - Org Name:TEXAS BARIATRIC SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-464-7555
Mailing Address - Street 1:407 PUEBLO PINTADO
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4725
Mailing Address - Country:US
Mailing Address - Phone:713-464-7555
Mailing Address - Fax:713-464-0219
Practice Address - Street 1:8038 WURZBACH RD # 650B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3817
Practice Address - Country:US
Practice Address - Phone:713-464-7555
Practice Address - Fax:713-464-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI48955Medicare UPIN