Provider Demographics
NPI:1467862078
Name:A CUT ABOVE SURGICAL ASSISTANT SERVICES LLC
Entity Type:Organization
Organization Name:A CUT ABOVE SURGICAL ASSISTANT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OUTRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-803-1794
Mailing Address - Street 1:134 VINTAGE PARK BLVD STE A-172
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3998
Mailing Address - Country:US
Mailing Address - Phone:225-803-1794
Mailing Address - Fax:
Practice Address - Street 1:134 VINTAGE PARK BLVD STE A-172
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3998
Practice Address - Country:US
Practice Address - Phone:225-803-1794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty