Provider Demographics
NPI:1710231485
Name:KATY SURGICAL ASSISTANTS, INC
Entity Type:Organization
Organization Name:KATY SURGICAL ASSISTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAND
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:III
Authorized Official - Credentials:LSA
Authorized Official - Phone:713-301-9330
Mailing Address - Street 1:4010 FULFORD CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5239
Mailing Address - Country:US
Mailing Address - Phone:713-301-9330
Mailing Address - Fax:281-398-0451
Practice Address - Street 1:4010 FULFORD CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5239
Practice Address - Country:US
Practice Address - Phone:713-301-9330
Practice Address - Fax:281-398-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty