Provider Demographics
NPI:1891049748
Name:PARAMOUNT SURGICAL ASSISTANTS LLC
Entity Type:Organization
Organization Name:PARAMOUNT SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B A
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LSA / CSA
Authorized Official - Phone:832-559-3870
Mailing Address - Street 1:8215 LICHEN LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4517
Mailing Address - Country:US
Mailing Address - Phone:832-559-3870
Mailing Address - Fax:270-778-3909
Practice Address - Street 1:8215 LICHEN LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4517
Practice Address - Country:US
Practice Address - Phone:832-559-3870
Practice Address - Fax:270-778-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00319363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty