Provider Demographics
NPI:1306004650
Name:CUTTING EDGE SURGICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:CUTTING EDGE SURGICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-777-4539
Mailing Address - Street 1:9494 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 620A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1419
Mailing Address - Country:US
Mailing Address - Phone:713-777-4539
Mailing Address - Fax:713-777-4542
Practice Address - Street 1:9494 SOUTHWEST FWY
Practice Address - Street 2:SUITE 620A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1419
Practice Address - Country:US
Practice Address - Phone:713-777-4539
Practice Address - Fax:713-777-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty