Provider Demographics
NPI:1477930675
Name:PRESTIGE SURGICAL ASSISTANTS
Entity Type:Organization
Organization Name:PRESTIGE SURGICAL ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAY
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:713-877-0600
Mailing Address - Street 1:2100 WEST LOOP S
Mailing Address - Street 2:1200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3515
Mailing Address - Country:US
Mailing Address - Phone:713-877-0600
Mailing Address - Fax:
Practice Address - Street 1:2100 WEST LOOP S
Practice Address - Street 2:1200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3515
Practice Address - Country:US
Practice Address - Phone:713-877-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty