# SPORTSMAN'S PARADISE SURGICAL ASSISTANTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780285171
- **Authorized official:** HENRY HAYDEL II (OWNER)
- **Authorized official phone:** (713) 589-8606

## Contact information

- **Practice address:** 401 LIBERTY ST, HOUMA, LA 70360-4617
- **Practice address phone:** (713) 589-8606
- **Mailing address:** PO BOX 8219, THE WOODLANDS, TX 77387-8219
- **Mailing address phone:** (737) 999-0321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2020
- **Last updated:** 11/03/2020