Provider Demographics
NPI:1417617630
Name:ERTHAL DE MAGALHAES LESSA, GISELLE (CSA)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:ERTHAL DE MAGALHAES LESSA
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 HIGHWAY 6 STE 10
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4917
Mailing Address - Country:US
Mailing Address - Phone:832-532-7100
Mailing Address - Fax:832-532-7410
Practice Address - Street 1:1111 HIGHWAY 6 STE 10
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4917
Practice Address - Country:US
Practice Address - Phone:832-532-7100
Practice Address - Fax:832-532-7410
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant