Provider Demographics
NPI:1144793175
Name:PICARDY SURGICAL ASSIST II, L.L.C.
Entity Type:Organization
Organization Name:PICARDY SURGICAL ASSIST II, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAMBLISS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARROD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-589-8606
Mailing Address - Street 1:2700 TECHNOLOGY FOREST BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3908
Mailing Address - Country:US
Mailing Address - Phone:737-999-0321
Mailing Address - Fax:737-999-0321
Practice Address - Street 1:7425 BOCAGE BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1141
Practice Address - Country:US
Practice Address - Phone:737-999-0321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty