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Organization

MP SURGICAL ASSISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TORI BUMSTEAD (BILLING COORDINATOR)
(409) 429-8457
Entity
Organization

Contact information

Practice address
4012 DUVAL ST UNIT B, AUSTIN, TX 78751-5110
(936) 414-6747
Mailing address
4012 DUVAL ST UNIT B, AUSTIN, TX 78751-5110
(936) 414-6747

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0117X
Orthopaedic Surgery of the Spine Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician

Other

Enumeration date
07/25/2019
Last updated
07/25/2019
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