Provider Demographics
NPI:1144760208
Name:NEWBURY SURGICAL STAFFING
Entity Type:Organization
Organization Name:NEWBURY SURGICAL STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:COWANS
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:832-872-3794
Mailing Address - Street 1:10223 BROADWAY ST
Mailing Address - Street 2:SUITE P-284
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7880
Mailing Address - Country:US
Mailing Address - Phone:832-872-3794
Mailing Address - Fax:
Practice Address - Street 1:10223 BROADWAY ST
Practice Address - Street 2:SUITE P-284
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7880
Practice Address - Country:US
Practice Address - Phone:832-872-3794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty