Provider Demographics
NPI:1265858708
Name:SURGICAL SPECTRUM, LLC
Entity Type:Organization
Organization Name:SURGICAL SPECTRUM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-252-1315
Mailing Address - Street 1:PO BOX 735195
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-5195
Mailing Address - Country:US
Mailing Address - Phone:832-252-1315
Mailing Address - Fax:832-252-1039
Practice Address - Street 1:9301 SOUTHWEST FWY
Practice Address - Street 2:SUITE 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1510
Practice Address - Country:US
Practice Address - Phone:832-252-1315
Practice Address - Fax:832-252-1039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty