Provider Demographics
NPI:1073929576
Name:SPECIALTY SURGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:SPECIALTY SURGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PARIND
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-306-8065
Mailing Address - Street 1:PO BOX 1383
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77251-1383
Mailing Address - Country:US
Mailing Address - Phone:800-785-8765
Mailing Address - Fax:281-453-1945
Practice Address - Street 1:910 E SOUTHLAKE BLVD
Practice Address - Street 2:155
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6388
Practice Address - Country:US
Practice Address - Phone:972-556-2885
Practice Address - Fax:817-527-8480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty