Basic Information
Provider Information
NPI: 1689205718
EntityType: 2
ReplacementNPI:  
OrganizationName: A CUT ABOVE SURGICAL ENTERPRISES, LLC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 2550
Address2:  
City: ROWLETT
State: TX
PostalCode: 750302550
CountryCode: US
TelephoneNumber: 2142272457
FaxNumber: 2147640880
Practice Location
Address1: 14383 DOUBLE DUTCH CIR
Address2:  
City: PARKER
State: CO
PostalCode: 801348866
CountryCode: US
TelephoneNumber: 2142272457
FaxNumber: 2147640880
Other Information
ProviderEnumerationDate: 01/28/2020
LastUpdateDate: 01/28/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: HASTINGS
AuthorizedOfficialFirstName: CASEY
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 2143967989
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: RNFA
NPICertificationDate: 01/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WR0006X  Y193400000X SINGLE SPECIALTY GROUPNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant

No ID Information.


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