Phenomsurgical Assisting
Specialist/Technologist, Other, Surgical Assistant in Fresno, TX. Organization (NPI-2).
NPI number1376901843
StatusActive
Last updated in NPPESApr 4, 2016
Details
- NPI
- 1376901843
- Entity type
- Organization (NPI-2)
- Legal business name
- Phenomsurgical Assisting
- Organization subpart
- No
- Enumeration date
- Jan 29, 2016
- Last updated
- Apr 4, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | SA00547 | TX | Yes |
Practice location
4026 E Teal Estates CirFresno, TX 77545-8851
Phone 510-984-8610
Mailing address
4026 E Teal Estates CirFresno, TX 77545-8851
Phone 510-984-8610
Authorized official
Gwendolyn Champion
Owner
5109848610
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