Organization
PASADENA SURGICAL ASSISTANT
Active
Organization
PASADENA SURGICAL ASSISTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM HERNANDEZ HERNANDEZ LSA (OWNER)
(832) 406-2427
Entity
Organization
Contact information
Practice address
2607 DIXIE WOODS DR, PEARLAND, TX 77581-5896
(832) 406-2427
Mailing address
PO BOX 34292, HOUSTON, TX 77234-4292
(832) 406-2427
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00448
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA00448
TEXAS MEDICAL BOARD - SURGICAL ASSISTANT'S PERMIT
TX
Enumeration date
11/18/2013
Last updated
05/26/2016
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