Provider Demographics
NPI:1932607074
Name:CAND A SURGICAL ASSISTANT SAND CONSULTANTS LLC.
Entity Type:Organization
Organization Name:CAND A SURGICAL ASSISTANT SAND CONSULTANTS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LENFORD
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:JR
Authorized Official - Credentials:CSA/CST
Authorized Official - Phone:832-967-4960
Mailing Address - Street 1:7759 GREENSWARTH LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-3607
Mailing Address - Country:US
Mailing Address - Phone:832-967-4960
Mailing Address - Fax:
Practice Address - Street 1:7759 GREENSWARTH LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-3607
Practice Address - Country:US
Practice Address - Phone:832-967-4960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty