Provider Demographics
NPI:1386143048
Name:COOX SURGICAL ASISSTANS MANAGEMENT CORPORATION
Entity type:Organization
Organization Name:COOX SURGICAL ASISSTANS MANAGEMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:ACEBO
Authorized Official - Suffix:JR
Authorized Official - Credentials:LSA
Authorized Official - Phone:832-713-9153
Mailing Address - Street 1:20023 SKY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5219
Mailing Address - Country:US
Mailing Address - Phone:832-713-9153
Mailing Address - Fax:281-676-4457
Practice Address - Street 1:20023 SKY HOLLOW LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5219
Practice Address - Country:US
Practice Address - Phone:832-713-9153
Practice Address - Fax:281-676-4457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193400000X246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1912058256OtherL.S.A