Provider Demographics
NPI:1578159083
Name:ALPHA SURGICAL ASSISTANTS LLC
Entity Type:Organization
Organization Name:ALPHA SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOERA DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:909-659-9388
Mailing Address - Street 1:1143 CLONMORE CT
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4016
Mailing Address - Country:US
Mailing Address - Phone:909-659-9388
Mailing Address - Fax:
Practice Address - Street 1:1143 CLONMORE CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4016
Practice Address - Country:US
Practice Address - Phone:909-254-3276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty