Provider Demographics
NPI:1700169851
Name:TSA SURGICAL ASSISTING SERVICE LLC
Entity Type:Organization
Organization Name:TSA SURGICAL ASSISTING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:YORK
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:832-264-1953
Mailing Address - Street 1:PO BOX 73024
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77273-3024
Mailing Address - Country:US
Mailing Address - Phone:832-264-1953
Mailing Address - Fax:
Practice Address - Street 1:111 VISON PARK BLVD.
Practice Address - Street 2:FIRST SURGICAL WOODLANDS TEXAS
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:936-271-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA000411171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty