Provider Demographics
NPI:1982926572
Name:INTEGRATED SURGICAL ASSIST LLC
Entity Type:Organization
Organization Name:INTEGRATED SURGICAL ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BRETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-768-6730
Mailing Address - Street 1:1449 HIGHWAY 6
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1449 HIGHWAY 6
Practice Address - Street 2:SUITE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5145
Practice Address - Country:US
Practice Address - Phone:281-768-6730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty