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Organization
SURGICAL FIRST ASSIST SPECIALIST OF SOUTH TEXAS
Active
Organization
SURGICAL FIRST ASSIST SPECIALIST OF SOUTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MCBAIN (CREDENTIALING SPECIALIST)
(972) 489-8535
Entity
Organization
Contact information
Practice address
2827 BABCOCK RD, SAN ANTONIO, TX 78229-4813
(972) 489-8535
Mailing address
1110 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092-5250
(972) 489-8535
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
10/26/2019
Last updated
10/26/2019
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