Provider Demographics
NPI:1104038496
Name:UNITED SURGICAL ASSISTANTS
Entity Type:Organization
Organization Name:UNITED SURGICAL ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:713-520-0658
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-1026
Mailing Address - Country:US
Mailing Address - Phone:713-520-0658
Mailing Address - Fax:713-522-9618
Practice Address - Street 1:1200 BINZ ST
Practice Address - Street 2:SUITE 1275
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6900
Practice Address - Country:US
Practice Address - Phone:713-520-0658
Practice Address - Fax:713-522-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00162208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0088KNOtherBLUE CROSS BLUE SHIELD