Provider Demographics
NPI:1518346683
Name:FIRST CHOICE SURGICAL ASSISTANT SERVICE,LLC
Entity type:Organization
Organization Name:FIRST CHOICE SURGICAL ASSISTANT SERVICE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:JR
Authorized Official - Credentials:CSFA
Authorized Official - Phone:956-252-5306
Mailing Address - Street 1:5111 N.10TH ST. PMB 172
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2835
Mailing Address - Country:US
Mailing Address - Phone:956-252-5306
Mailing Address - Fax:956-287-7699
Practice Address - Street 1:5111 N.10TH ST. PMB 172
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2835
Practice Address - Country:US
Practice Address - Phone:956-252-5306
Practice Address - Fax:956-287-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88256246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty