1003199506 NPI number — SANTAELLA SURGICAL SERVICES PA

Table of content: DR. THOMAS GUS ALMONROEDER D.P.T. (NPI 1598102576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003199506 NPI number — SANTAELLA SURGICAL SERVICES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANTAELLA SURGICAL SERVICES PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003199506
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6898 LEBANON RD
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034-7473
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-335-7874
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6898 LEBANON RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-7473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-335-7874
Provider Business Practice Location Address Fax Number:
214-872-3455
Provider Enumeration Date:
09/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SANTAELLA
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
O
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
972-335-7874

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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