Provider Demographics
NPI:1205363330
Name:TEXAS PRINCIPAL SURGICAL ASSISTANTS
Entity Type:Organization
Organization Name:TEXAS PRINCIPAL SURGICAL ASSISTANTS
Other - Org Name:TEXAS PRINCIPAL SURGICAL ASSISTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:713-575-0830
Mailing Address - Street 1:18538 WOLF CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3041
Mailing Address - Country:US
Mailing Address - Phone:713-575-0830
Mailing Address - Fax:
Practice Address - Street 1:22999 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4412
Practice Address - Country:US
Practice Address - Phone:713-575-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00594246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty