Organization
EXCELLENT SURGICAL ASSIST GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHEA RENA HAMILTON CSA (PRESIDENT)
(972) 345-5074
Entity
Organization
Contact information
Practice address
924 WHITEWATER TRL, DESOTO, TX 75115-5443
(972) 345-5074
Mailing address
924 WHITEWATER TRL, DESOTO, TX 75115-5443
(972) 345-5074
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
3354
TX
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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