Provider Demographics
NPI:1619315041
Name:MEXLIFE SURGICAL ASSISTANT SERVICE, LLC
Entity Type:Organization
Organization Name:MEXLIFE SURGICAL ASSISTANT SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:832-576-2380
Mailing Address - Street 1:PO BOX 18042
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-8042
Mailing Address - Country:US
Mailing Address - Phone:281-653-2924
Mailing Address - Fax:713-583-5766
Practice Address - Street 1:2502 INDIAN PLAINS LANE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:713-882-6889
Practice Address - Fax:281-261-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty