Organization
THE SURGERY PRO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE OTAMIRI LSA (OWNER)
(214) 227-2457
Entity
Organization
Contact information
Practice address
9355 JOHN W ELLIOTT DR STE 25461, FRISCO, TX 75033-3665
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
12/27/2021
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