1538515325 NPI number — APEX SURGICAL ASSISTANTS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538515325 NPI number — APEX SURGICAL ASSISTANTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APEX SURGICAL ASSISTANTS
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:
1538515325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 294
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUMBLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77347-0294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-760-6591
Provider Business Mailing Address Fax Number:
936-582-6013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17450 ST LUKES WAY
Provider Second Line Business Practice Location Address:
STE 400
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-760-6591
Provider Business Practice Location Address Fax Number:
936-582-6013
Provider Enumeration Date:
05/11/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YARRITO
Authorized Official First Name:
ELIAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
936-760-6591

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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