Organization
PREFERRED SURGICAL ASSOCIATES OF TEXAS
Active
Organization
PREFERRED SURGICAL ASSOCIATES OF TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNY RAY STATON LSA (DIRECTOR)
(214) 980-9437
Entity
Organization
Contact information
Practice address
1208 PAINTBRUSH ST, MESQUITE, TX 75149-2634
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 938, ROWLETT, TX 75030-0938
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922530591
—
TX
Enumeration date
01/08/2018
Last updated
04/25/2019
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