Provider Demographics
NPI:1659987352
Name:TMB SURGICAL ASSTANT
Entity Type:Organization
Organization Name:TMB SURGICAL ASSTANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL FIRST ASSIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISTO
Authorized Official - Suffix:
Authorized Official - Credentials:ALLIED HEALTH
Authorized Official - Phone:713-405-0230
Mailing Address - Street 1:PO BOX 681381
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268
Mailing Address - Country:US
Mailing Address - Phone:713-405-0230
Mailing Address - Fax:
Practice Address - Street 1:5007 FM 1960 RD W
Practice Address - Street 2:# 334
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069
Practice Address - Country:US
Practice Address - Phone:713-405-0230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty