Organization
SPORTSMAN'S PARADISE SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY HAYDEL II (OWNER)
(713) 589-8606
Entity
Organization
Contact information
Practice address
401 LIBERTY ST, HOUMA, LA 70360-4617
(713) 589-8606
Mailing address
PO BOX 8219, THE WOODLANDS, TX 77387-8219
(737) 999-0321
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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