Organization
LONE STAR NEUROSURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDOLREZA SIADATI (PRESIDENT)
(469) 878-4021
Entity
Organization
Contact information
Practice address
1270 CASA BELLA CT, WESTLAKE, TX 76262
(469) 878-4021
Mailing address
1270 CASA BELLA CT, WESTLAKE, TX 76262
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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