1043675101 NPI number — HIGH PLAINS SURGICAL ASSISTANTS, LLC

Table of content: DR. SORAYA ANNE ROSS MD (NPI 1649209628)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043675101 NPI number — HIGH PLAINS SURGICAL ASSISTANTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGH PLAINS SURGICAL ASSISTANTS, LLC
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:
1043675101
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10940 S PARKER RD STE 226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARKER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80134-7440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-305-6205
Provider Business Mailing Address Fax Number:
866-209-2816

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10940 S PARKER RD STE 226
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARKER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80134-7440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-305-6205
Provider Business Practice Location Address Fax Number:
866-209-2816
Provider Enumeration Date:
12/16/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FARMER
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
DOUGLAS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
720-305-6205

Provider Taxonomy Codes

  • Taxonomy code: 246ZC0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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