Provider Demographics
NPI:1508253329
Name:TRIUMPH SURGICAL ASSISTANTS PA
Entity Type:Organization
Organization Name:TRIUMPH SURGICAL ASSISTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:JEJURIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-827-2814
Mailing Address - Street 1:9101 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5927
Mailing Address - Country:US
Mailing Address - Phone:214-827-2814
Mailing Address - Fax:469-375-3821
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:SUITE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-827-2814
Practice Address - Fax:469-375-3821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty