Provider Demographics
NPI:1538504097
Name:SURGASSIST PRO LLC
Entity Type:Organization
Organization Name:SURGASSIST PRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHACON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-378-3870
Mailing Address - Street 1:5880 ASHMILL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0031
Mailing Address - Country:US
Mailing Address - Phone:972-378-3870
Mailing Address - Fax:972-378-7977
Practice Address - Street 1:5880 ASHMILL DR STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0031
Practice Address - Country:US
Practice Address - Phone:972-378-3870
Practice Address - Fax:972-378-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty