Provider Demographics
NPI:1346793031
Name:SLM SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:SLM SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:346-221-1597
Mailing Address - Street 1:PO BOX 1651
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-1651
Mailing Address - Country:US
Mailing Address - Phone:346-221-1597
Mailing Address - Fax:888-832-5078
Practice Address - Street 1:3206 SERENE OAK DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4431
Practice Address - Country:US
Practice Address - Phone:346-221-1597
Practice Address - Fax:832-581-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00438246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00438OtherSTATE LICENSE NUMBER