Provider Demographics
NPI:1215205521
Name:SURGICAL MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:SURGICAL MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:210-241-8433
Mailing Address - Street 1:623 MARLYS AVE
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-1997
Mailing Address - Country:US
Mailing Address - Phone:210-241-8433
Mailing Address - Fax:877-334-0715
Practice Address - Street 1:623 MARLYS AVE
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-1997
Practice Address - Country:US
Practice Address - Phone:210-241-8433
Practice Address - Fax:877-334-0715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty