Provider Demographics
NPI:1003144817
Name:NOVA SURGICAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:NOVA SURGICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:713-817-3127
Mailing Address - Street 1:2326 BASTROP ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-1402
Mailing Address - Country:US
Mailing Address - Phone:713-817-3127
Mailing Address - Fax:832-436-1726
Practice Address - Street 1:2326 BASTROP ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-1402
Practice Address - Country:US
Practice Address - Phone:713-817-3127
Practice Address - Fax:832-436-1726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty