Organization
PRO ALLY SURGICAL
Active
Organization
PRO ALLY SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY PANIAGUA (PRESIDENT)
(305) 972-1002
Entity
Organization
Contact information
Practice address
315 ADDICKS HOWELL RD UNIT 940561, HOUSTON, TX 77094-2323
(305) 972-1002
Mailing address
315 ADDICKS HOWELL RD UNIT 940561, HOUSTON, TX 77094-2323
(305) 972-1002
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
SA00477
TX
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA00477
TEXAS MEDICAL BOARD
TX
Enumeration date
02/25/2014
Last updated
10/28/2023
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