Provider Demographics
NPI:1215238993
Name:FARIAS SURGICAL FIRST ASSISTING LLC
Entity type:Organization
Organization Name:FARIAS SURGICAL FIRST ASSISTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:GALVAN
Authorized Official - Last Name:FARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:1800-707-0057
Mailing Address - Street 1:6951 RAINTREE GRV UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ELMENDORF
Mailing Address - State:TX
Mailing Address - Zip Code:78112-7904
Mailing Address - Country:US
Mailing Address - Phone:210-787-9552
Mailing Address - Fax:
Practice Address - Street 1:6951 RAINTREE GRV UNIT 2
Practice Address - Street 2:
Practice Address - City:ELMENDORF
Practice Address - State:TX
Practice Address - Zip Code:78112-7904
Practice Address - Country:US
Practice Address - Phone:210-787-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty