Organization
DIVINE SURGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZEMORAH ISRAEL LSA (OWNER/ CEO)
(800) 801-9297
Entity
Organization
Contact information
Practice address
110 NINA LN, STAFFORD, TX 77477-4647
(800) 801-9297
Mailing address
PO BOX 97, STAFFORD, TX 77497-0097
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/12/2021
Last updated
01/25/2022
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