Organization
STAR SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGELIO GUARDIOLA JR. SA-C (SURGICAL ASSISTANT)
(210) 863-8127
Entity
Organization
Contact information
Practice address
941 MITCH THOMAS, PLEASANTON, TX 78064-4827
(210) 863-8127
Mailing address
941 MITCH THOMAS, PLEASANTON, TX 78064-4827
(210) 863-8127
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
10-124
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-124
CERTIFICATION
CO
Enumeration date
01/23/2014
Last updated
01/23/2014
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