Provider Demographics
NPI:1972074532
Name:NATIONWIDE SURGICAL RESOURCES LLC
Entity type:Organization
Organization Name:NATIONWIDE SURGICAL RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:MAZEN
Authorized Official - Last Name:SAIJARI
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:713-409-5544
Mailing Address - Street 1:PO BOX 572016
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77257-2016
Mailing Address - Country:US
Mailing Address - Phone:214-390-7697
Mailing Address - Fax:972-432-6692
Practice Address - Street 1:7600 BURGOYNE RD UNIT 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3104
Practice Address - Country:US
Practice Address - Phone:214-390-7697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty