Organization
EXCELSA SURGICAL ASSISTANT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE TAVARES-ALVARADO LSA (OWNER)
(281) 827-6521
Entity
Organization
Contact information
Practice address
1826 PLEASANT SPRINGS LN, HOUSTON, TX 77089-1498
(281) 827-6521
Mailing address
PO BOX 751763, HOUSTON, TX 77275-1763
(281) 827-6521
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
06/11/2020
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