Organization
AGILE SURGICAL ASSISTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGIO GILES LSA (CHAIRMAN/CEO)
(817) 713-8905
Entity
Organization
Contact information
Practice address
8428 WHIPPOORWILL DR, FORT WORTH, TX 76123-1996
(817) 713-8905
(817) 394-1427
Mailing address
8428 WHIPPOORWILL DR, FORT WORTH, TX 76123-1996
(817) 713-8905
(817) 394-1427
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
SA00564
TX
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/17/2017
Last updated
04/29/2017
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