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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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