Organization
OLTON SURGICAL SERVICES, LLC
Active
Organization
OLTON SURGICAL SERVICES, LLC
Active
Other names
Olton Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
KATHYANN CYNTHELESE BRYANT LSA (LICENSED SURGICAL ASSISTANT)
(832) 523-3066
Entity
Organization
Contact information
Practice address
3375 WESTPARK DR, UNIT 442, HOUSTON, TX 77005-4262
(832) 523-3066
(832) 602-2638
Mailing address
PO BOX 541602, HOUSTON, TX 77254-1602
(832) 523-3066
(832) 602-2638
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
—
—
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00P07U
BCBS - OLTON SURGICAL SERVICES, LLC
TX
01
—
SA00606
SURGICAL ASSISTANT'S LICENSE
TX
Enumeration date
05/09/2016
Last updated
10/13/2020
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