Organization
CYNTHIA FUENTES LSA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA FUENTES LSA (LICENSED SURGICAL ASSISTANT)
(469) 231-5309
Entity
Organization
Contact information
Practice address
10015 HERITAGE PL, DALLAS, TX 75217-7771
(469) 231-5309
(972) 913-0544
Mailing address
PO BOX 156, WAXAHACHIE, TX 75168-0156
(469) 231-5309
(972) 913-0544
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
SA00072
TX
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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