Provider Demographics
NPI:1558990903
Name:ANSURIO EXCEED ASSOCIATES INC.
Entity Type:Organization
Organization Name:ANSURIO EXCEED ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ANSURIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:JR
Authorized Official - Credentials:LSA
Authorized Official - Phone:214-208-6286
Mailing Address - Street 1:PO BOX 77934
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-0934
Mailing Address - Country:US
Mailing Address - Phone:214-208-6286
Mailing Address - Fax:
Practice Address - Street 1:11800 HORSESHOE RIDGE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4892
Practice Address - Country:US
Practice Address - Phone:214-208-6286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty