Basic Information
| Provider Information | |||||||||
| NPI: | 1811295785 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICIAN CHOICE ASSISTING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13161 MISTY WILLOW DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770705635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819705900 | ||||||||
| FaxNumber: | 2819705913 | ||||||||
| Practice Location | |||||||||
| Address1: | 13161 MISTY WILLOW DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770705635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819705900 | ||||||||
| FaxNumber: | 2819705913 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2011 | ||||||||
| LastUpdateDate: | 03/02/2011 | ||||||||
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| AuthorizedOfficialLastName: | PURDON | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 8325853897 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PHS HOLDINGS | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | BBA,CNIM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA03999 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.