Avalon Surgical PC
Physician Assistant, Surgical in Denver, CO. Organization (NPI-2).
NPI number1962896563
StatusActive
Last updated in NPPESMar 23, 2015
Details
- NPI
- 1962896563
- Entity type
- Organization (NPI-2)
- Legal business name
- Avalon Surgical PC
- Organization subpart
- No
- Enumeration date
- Mar 23, 2015
- Last updated
- Mar 23, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | CO | Yes |
Practice location
700 Colorado BlvdSte 115
Denver, CO 80206-4084
Phone 281-324-5660
Mailing address
Po Box 1288Crosby, TX 77532-1288
Phone 281-324-5660
Authorized official
Fred J Diss
Registered Agent
2813245660
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