Organization
SPECIAL OPS STAFFING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BOUTTE LSA (OWNER)
(214) 364-6769
Entity
Organization
Contact information
Practice address
7512 FOREST BEND DR, PARKER, TX 75002-6823
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 831597, RICHARDSON, TX 75083-1597
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
07/02/2018
Last updated
08/06/2019
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