Individual
MR. JACK LOUIS ADDESSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RSA
Contact information
Practice address
7324 SOUTHWEST FREEWAY, SUITE 1550, HOUSTON, TX 77074-2053
(713) 779-9800
(713) 779-9813
Mailing address
7324 SOUTHWEST FREEWAY, SUITE 1550, HOUSTON, TX 77074
(713) 779-9800
(713) 779-9813
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.000021
IL
246ZS0410X
Surgical Technologist
238.000021
IL
363AS0400X
Surgical Physician Assistant
Primary
238.000021
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238.000021
REGISTERED SURGICAL ASST.
IL
Enumeration date
02/26/2007
Last updated
10/04/2018
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