Provider Demographics
NPI:1184080970
Name:ASSURGENT SURGICAL ASSISTING OF EAST TEXAS LLC
Entity type:Organization
Organization Name:ASSURGENT SURGICAL ASSISTING OF EAST TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOLORZANO
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:936-635-1492
Mailing Address - Street 1:6682 FM 842
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-2200
Mailing Address - Country:US
Mailing Address - Phone:926-635-1492
Mailing Address - Fax:
Practice Address - Street 1:6682 FM 842
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-2200
Practice Address - Country:US
Practice Address - Phone:936-635-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty