Provider Demographics
NPI:1871830968
Name:MEXLIFE SURGICAL ASSISTANT SERVICE
Entity Type:Organization
Organization Name:MEXLIFE SURGICAL ASSISTANT SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:281-653-2924
Mailing Address - Street 1:PO BOX 18042
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-8042
Mailing Address - Country:US
Mailing Address - Phone:281-653-2924
Mailing Address - Fax:713-583-5766
Practice Address - Street 1:2502 INDIAN PLAINS LANE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1262
Practice Address - Country:US
Practice Address - Phone:281-463-6309
Practice Address - Fax:713-583-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty