Organization
FALL CREEK SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY B MCCLEERY LSA (PRESIDENT)
(817) 605-0991
Entity
Organization
Contact information
Practice address
1504 KELSEY DR, KELLER, TX 76248-6878
(817) 605-0991
(817) 605-0993
Mailing address
PO BOX 820428, NORTH RICHLAND HILLS, TX 76182-0428
(817) 605-0991
(817) 605-0993
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00132
TX
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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