Provider Demographics
NPI:1376670497
Name:SURGICAL FIRST ASSISTANT SERVICES INC
Entity Type:Organization
Organization Name:SURGICAL FIRST ASSISTANT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:E
Authorized Official - Last Name:PRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:409-735-7493
Mailing Address - Street 1:6226 INEZ AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-7698
Mailing Address - Country:US
Mailing Address - Phone:409-735-7493
Mailing Address - Fax:409-697-1104
Practice Address - Street 1:6226 INEZ AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-7698
Practice Address - Country:US
Practice Address - Phone:409-735-7493
Practice Address - Fax:409-697-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00048246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty