Provider Demographics
NPI:1740640093
Name:AE SURGICAL ASSISTANTS, LLC
Entity type:Organization
Organization Name:AE SURGICAL ASSISTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHIANIRA
Authorized Official - Middle Name:ANA
Authorized Official - Last Name:ESPEJO
Authorized Official - Suffix:
Authorized Official - Credentials:LSA, CSFA
Authorized Official - Phone:832-725-8265
Mailing Address - Street 1:4134 FALSE CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-1131
Mailing Address - Country:US
Mailing Address - Phone:832-725-8265
Mailing Address - Fax:
Practice Address - Street 1:4134 FALSE CYPRESS LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-1131
Practice Address - Country:US
Practice Address - Phone:832-725-8265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00629363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty