Provider Demographics
NPI:1164904645
Name:JB SURGICAL INC
Entity Type:Organization
Organization Name:JB SURGICAL INC
Other - Org Name:JB SURGICAL INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:BARILLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:832-633-0099
Mailing Address - Street 1:PO BOX 691789
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1789
Mailing Address - Country:US
Mailing Address - Phone:281-653-2924
Mailing Address - Fax:
Practice Address - Street 1:12955 WILLOW PLACE DR W # 691789
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5651
Practice Address - Country:US
Practice Address - Phone:281-653-2924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty