Individual
SERGIO O GILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA, CSA, CSFA
Contact information
Practice address
7060 HEATHER DR, BRYANS ROAD, MD 20616-4234
(682) 426-8974
Mailing address
7060 HEATHER DR, BRYANS ROAD, MD 20616-4234
(682) 426-8974
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00564
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183346
CERTIFIED SURGICAL FIRST ASSISTANT
—
01
—
3143
CERTIFIED SURGICAL ASSISTANT
—
01
—
SA00564
LICENSE SURGICAL ASSISTANT
TX
Enumeration date
09/21/2011
Last updated
09/24/2025
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