Provider Demographics
NPI:1932692308
Name:MSMRSURGICAL SPECIALIST INC.
Entity Type:Organization
Organization Name:MSMRSURGICAL SPECIALIST INC.
Other - Org Name:MSMR SURGICAL SPECIALIST INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED NURSE FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:RAWLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:214-549-9149
Mailing Address - Street 1:303 STONE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-2639
Mailing Address - Country:US
Mailing Address - Phone:214-549-9149
Mailing Address - Fax:
Practice Address - Street 1:303 STONE MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-2639
Practice Address - Country:US
Practice Address - Phone:214-549-9149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677521163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty