Provider Demographics
NPI:1417503467
Name:SUPERIOR SURGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:SUPERIOR SURGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:AMY
Authorized Official - Last Name:PENNIE
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:832-656-0597
Mailing Address - Street 1:P.O. BOX 19368
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496
Mailing Address - Country:US
Mailing Address - Phone:832-656-0597
Mailing Address - Fax:
Practice Address - Street 1:5527 YORKWOOD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016
Practice Address - Country:US
Practice Address - Phone:832-656-0597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty