Provider Demographics
NPI:1285995803
Name:MCGRATH, ASHLEY SUTTON (LSA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUTTON
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25555 PACER CIR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2871
Mailing Address - Country:US
Mailing Address - Phone:832-527-9351
Mailing Address - Fax:
Practice Address - Street 1:1 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3560
Practice Address - Country:US
Practice Address - Phone:832-655-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
TX130758246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8MD882OtherBCBS - UNIVERSAL SURGICAL PARTNERS INC
TX8MD924OtherBCBS - BLUE STAR SURGICAL ASSISTANTS LLC
TXSA00784OtherTEXAS MEDICAL BOARD
TX8MD916OtherBCBS - UNIVERSAL SURGICAL ASSISTANTS
TX8MD883OtherBCBS - XCITE SURGICAL