Provider Demographics
NPI:1558631457
Name:AIDE SURGICAL ASSISTANTS INC
Entity Type:Organization
Organization Name:AIDE SURGICAL ASSISTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTELONGO
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:832-455-1729
Mailing Address - Street 1:PO BOX 4514
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-0514
Mailing Address - Country:US
Mailing Address - Phone:832-455-1729
Mailing Address - Fax:
Practice Address - Street 1:1206 CHRISTINE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-4830
Practice Address - Country:US
Practice Address - Phone:832-455-1729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty