Provider Demographics
NPI:1235424433
Name:SURGEONS CHOICE SURGICAL FIRST ASSISTANT
Entity Type:Organization
Organization Name:SURGEONS CHOICE SURGICAL FIRST ASSISTANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:214-378-9898
Mailing Address - Street 1:1000 GLENCREST DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2926
Mailing Address - Country:US
Mailing Address - Phone:214-378-9898
Mailing Address - Fax:214-378-9888
Practice Address - Street 1:1000 GLENCREST DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2926
Practice Address - Country:US
Practice Address - Phone:214-378-9898
Practice Address - Fax:214-378-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX577126174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0009QEOtherBLUE CROSS BLUE SHIELD
TX613607200OtherWORKERS COMP