Provider Demographics
NPI:1689001695
Name:PRECISION SURGICAL, INC
Entity Type:Organization
Organization Name:PRECISION SURGICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:303-525-1698
Mailing Address - Street 1:PO BOX 461206
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80046-1206
Mailing Address - Country:US
Mailing Address - Phone:303-525-1698
Mailing Address - Fax:303-827-3402
Practice Address - Street 1:19696 E PINEWOOD DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-3880
Practice Address - Country:US
Practice Address - Phone:303-525-1698
Practice Address - Fax:303-827-3402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1184725095OtherINDIVIDUAL NPI
CO1538596861OtherINDIVIDUAL NPI