Provider Demographics
NPI:1982193132
Name:FITCH SURGICAL ASSISTING GROUP, LLC
Entity Type:Organization
Organization Name:FITCH SURGICAL ASSISTING GROUP, LLC
Other - Org Name:SELF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LSA
Authorized Official - Prefix:
Authorized Official - First Name:CHIZELLE
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:FITCH
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:210-900-5337
Mailing Address - Street 1:6163 JOHN CHAPMAN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240
Mailing Address - Country:US
Mailing Address - Phone:210-900-5337
Mailing Address - Fax:
Practice Address - Street 1:6163 JOHN CHAPMAN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-900-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00651246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty