Provider Demographics
NPI:1134636632
Name:EXPERT HANDS SURGERY
Entity Type:Organization
Organization Name:EXPERT HANDS SURGERY
Other - Org Name:EXPERT HANDS SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:NORBE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:BASULTO
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:786-556-8819
Mailing Address - Street 1:29310 PRAIRIE ROSE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7384
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29310 PRAIRIE ROSE CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7384
Practice Address - Country:US
Practice Address - Phone:786-556-8819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00474363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty