Provider Demographics
NPI:1083896633
Name:TEAM SURGICAL ASSIST, PLLC
Entity Type:Organization
Organization Name:TEAM SURGICAL ASSIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOMBS
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICIAN ASSISTANT
Authorized Official - Phone:210-269-9979
Mailing Address - Street 1:407 CRAIGMONT LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-3837
Mailing Address - Country:US
Mailing Address - Phone:210-269-9979
Mailing Address - Fax:210-979-6011
Practice Address - Street 1:407 CRAIGMONT LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-3837
Practice Address - Country:US
Practice Address - Phone:210-269-9979
Practice Address - Fax:210-979-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02118363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty