Provider Demographics
NPI:1871653998
Name:CORPUS CHRISTI SURGICAL ASSISTANTS, INC.
Entity Type:Organization
Organization Name:CORPUS CHRISTI SURGICAL ASSISTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:361-548-9515
Mailing Address - Street 1:2426 SONGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3936
Mailing Address - Country:US
Mailing Address - Phone:361-548-9515
Mailing Address - Fax:361-334-9114
Practice Address - Street 1:2426 SONGBIRD LN
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3936
Practice Address - Country:US
Practice Address - Phone:361-548-9515
Practice Address - Fax:361-334-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX062461163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID