Provider Demographics
NPI:1841510021
Name:SURGICAL STAFFING, LLC
Entity type:Organization
Organization Name:SURGICAL STAFFING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LOOP
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:214-954-7304
Mailing Address - Street 1:PO BOX 740383
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-0383
Mailing Address - Country:US
Mailing Address - Phone:214-954-7304
Mailing Address - Fax:
Practice Address - Street 1:7601 CHURCHILL WAY APT 621
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1958
Practice Address - Country:US
Practice Address - Phone:214-954-7304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653305163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty