Basic Information
| Provider Information | |||||||||
| NPI: | 1255692018 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUGAR LAND SURGICAL ASSISTANTS, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16605 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 285 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774793501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813130031 | ||||||||
| FaxNumber: | 2813130032 | ||||||||
| Practice Location | |||||||||
| Address1: | 16605 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 285 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774793501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813130031 | ||||||||
| FaxNumber: | 2813130032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2012 | ||||||||
| LastUpdateDate: | 06/07/2012 | ||||||||
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| AuthorizedOfficialLastName: | BINDAL | ||||||||
| AuthorizedOfficialFirstName: | RAJESH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2813130031 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 807047 | TX | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LA2100X | 654315 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.