Provider Demographics
NPI:1720357411
Name:PARETS, ERNESTO RAFAEL (SURGICAL ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:RAFAEL
Last Name:PARETS
Suffix:
Gender:M
Credentials:SURGICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 BLACK SKIMMER CT
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7773
Mailing Address - Country:US
Mailing Address - Phone:181-889-4922
Mailing Address - Fax:
Practice Address - Street 1:2521 BLACK SKIMMER CT
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7773
Practice Address - Country:US
Practice Address - Phone:181-889-4922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-25
Last Update Date:2011-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11-221246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist