Provider Demographics
NPI:1578229407
Name:PRECISION SURGICAL ASSISTANTS
Entity Type:Organization
Organization Name:PRECISION SURGICAL ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:R
Authorized Official - Last Name:FONSECA
Authorized Official - Suffix:
Authorized Official - Credentials:LSA, SA-C
Authorized Official - Phone:832-646-8021
Mailing Address - Street 1:5600 SAINT MORITZ ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2617
Mailing Address - Country:US
Mailing Address - Phone:832-646-8021
Mailing Address - Fax:
Practice Address - Street 1:5600 SAINT MORITZ ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2617
Practice Address - Country:US
Practice Address - Phone:832-646-8021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty