Provider Demographics
NPI:1053847384
Name:SURE HANDS SURGICAL ASSISTING LLC
Entity Type:Organization
Organization Name:SURE HANDS SURGICAL ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:832-428-1862
Mailing Address - Street 1:2126 BEACON LIGHT LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7089
Mailing Address - Country:US
Mailing Address - Phone:832-428-1862
Mailing Address - Fax:
Practice Address - Street 1:2126 BEACON LIGHT LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7089
Practice Address - Country:US
Practice Address - Phone:832-428-1862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4081174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14597320OtherTDL