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Organization

PROFESSIONAL SURGICAL ASSISTANT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIA J VILLATORO LSA (LICENSE SURGICAL ASSISTANT)
(832) 812-8342
Entity
Organization

Contact information

Practice address
17914 DOVETAIL CREEK CT, CYPRESS, TX 77433-7208
(832) 812-8342
Mailing address
PO BOX 1156, CYPRESS, TX 77410
(832) 812-8342

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8SQ944
XCITE SURGICAL
TX
01
8SY054
BLUE STAR SURGICAL ASSISTANTS
TX
01
8SY135
US MSO
TX
Enumeration date
03/07/2019
Last updated
10/23/2024
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