Provider Demographics
NPI:1104195932
Name:MEJIA SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:MEJIA SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:210-683-4452
Mailing Address - Street 1:12902 ESSEN FRST
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-3790
Mailing Address - Country:US
Mailing Address - Phone:210-683-4452
Mailing Address - Fax:
Practice Address - Street 1:12902 ESSEN FRST
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-3790
Practice Address - Country:US
Practice Address - Phone:210-683-4452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty