Provider Demographics
NPI:1043496557
Name:FOUR HANDS SURGICAL ASSISTANT CO.
Entity Type:Organization
Organization Name:FOUR HANDS SURGICAL ASSISTANT CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIERK
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING AGENCY
Authorized Official - Phone:409-925-0332
Mailing Address - Street 1:PO BOX 588
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-0588
Mailing Address - Country:US
Mailing Address - Phone:409-925-0332
Mailing Address - Fax:409-925-1562
Practice Address - Street 1:1221 MCKINNEY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77010-2011
Practice Address - Country:US
Practice Address - Phone:713-442-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
1656 TXOtherSURGEON ASISTANT