Provider Demographics
NPI:1093198970
Name:SOUTH TEXAS SURGICAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SOUTH TEXAS SURGICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUGGEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-373-3704
Mailing Address - Street 1:PO BOX 8308
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8308
Mailing Address - Country:US
Mailing Address - Phone:800-785-8765
Mailing Address - Fax:281-820-1901
Practice Address - Street 1:20770 US HIGHWAY 281 N
Practice Address - Street 2:#108-439
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7519
Practice Address - Country:US
Practice Address - Phone:281-820-1900
Practice Address - Fax:281-820-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty