Organization
SURGERY IN MOTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF BOUTTE SA-C (SURGICAL ASSISTANT)
(214) 364-6769
Entity
Organization
Contact information
Practice address
7512 FOREST BEND DR, PARKER, TX 75002-6823
(214) 364-6769
Mailing address
7512 FOREST BEND DR, PARKER, TX 75002-6823
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
09-195
TX
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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