Provider Demographics
NPI:1598115248
Name:SAN ANTONIO ASSISTING SERVICES, LLC
Entity Type:Organization
Organization Name:SAN ANTONIO ASSISTING SERVICES, LLC
Other - Org Name:SURGERY PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACCARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-614-8101
Mailing Address - Street 1:3463 MAGIC DR
Mailing Address - Street 2:SUITE T21
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2973
Mailing Address - Country:US
Mailing Address - Phone:210-614-8101
Mailing Address - Fax:
Practice Address - Street 1:3463 MAGIC DR
Practice Address - Street 2:SUITE T21
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2973
Practice Address - Country:US
Practice Address - Phone:210-614-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty