Provider Demographics
NPI:1215382775
Name:FIRST CHOICE SURGICAL ASSISTING
Entity type:Organization
Organization Name:FIRST CHOICE SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL FIRST ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:210-316-7815
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:POTEET
Mailing Address - State:TX
Mailing Address - Zip Code:78065-0411
Mailing Address - Country:US
Mailing Address - Phone:210-316-7815
Mailing Address - Fax:
Practice Address - Street 1:730 OAK CREEK ESTS
Practice Address - Street 2:
Practice Address - City:POTEET
Practice Address - State:TX
Practice Address - Zip Code:78065-4022
Practice Address - Country:US
Practice Address - Phone:210-316-7815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316386378OtherCMS