Provider Demographics
NPI:1992219737
Name:SIGNATURE SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:SIGNATURE SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:TITTO
Authorized Official - Middle Name:VARGHESE
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:832-474-0091
Mailing Address - Street 1:7114 BAITLAND DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2039
Mailing Address - Country:US
Mailing Address - Phone:832-474-0091
Mailing Address - Fax:
Practice Address - Street 1:7114 BAITLAND DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2039
Practice Address - Country:US
Practice Address - Phone:832-474-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty