Provider Demographics
NPI:1962750901
Name:SS SURGICAL ASSISTING, LLC
Entity type:Organization
Organization Name:SS SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:
Authorized Official - Credentials:OPA-C, LSA
Authorized Official - Phone:281-541-8872
Mailing Address - Street 1:2317 COBBLECREEK DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3703
Mailing Address - Country:US
Mailing Address - Phone:281-541-8872
Mailing Address - Fax:331-625-7932
Practice Address - Street 1:2317 COBBLECREEK DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3703
Practice Address - Country:US
Practice Address - Phone:281-541-8872
Practice Address - Fax:331-625-7932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-23
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty