Provider Demographics
NPI:1144779406
Name:GILES SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:GILES SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:432-230-5412
Mailing Address - Street 1:117 HIGHWAY 332 W STE J
Mailing Address - Street 2:SUITE 5 BOX 222
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4022
Mailing Address - Country:US
Mailing Address - Phone:432-230-5412
Mailing Address - Fax:
Practice Address - Street 1:117 HIGHWAY 332 W STE J
Practice Address - Street 2:SUITE 5 BOX 222
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4022
Practice Address - Country:US
Practice Address - Phone:432-230-5412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty