Organization
BASILISA SURGICAL ASSISTANT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL SALVADOR LOPEZ CARDENAS (OWNER)
(832) 908-7831
Entity
Organization
Contact information
Practice address
25200 INTERSTATE 45 APT 104, SPRING, TX 77386-1414
(832) 908-7831
Mailing address
330 RAYFORD RD STE 238, SPRING, TX 77386-1980
(832) 908-7831
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
04/04/2015
Last updated
04/04/2015
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