Provider Demographics
NPI:1093306144
Name:KATY SURGICAL ASSIST SERVICES, LLC
Entity Type:Organization
Organization Name:KATY SURGICAL ASSIST SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALCOSEBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-536-5726
Mailing Address - Street 1:403 NEW HOPE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0285
Mailing Address - Country:US
Mailing Address - Phone:281-536-5726
Mailing Address - Fax:
Practice Address - Street 1:403 NEW HOPE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0285
Practice Address - Country:US
Practice Address - Phone:281-536-5726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty