Prosurg Surgical Assisting LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

168736 Issued in TX

Legal business name

PROSURG SURGICAL ASSISTING LLC

Practice address

3077 N Goliad St
Rockwall, TX 75087-7050

Phone

(214) 906-2875

Fax

(972) 771-1825

NPI assigned

Jan 18, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mandy McCarver, CSFA

Title

President

Phone

(214) 906-2875

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1003352840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 N GOLIAD ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750877050",
            "telephone_number": "214-906-2875",
            "fax_number": "972-771-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 N GOLIAD ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750877050",
            "telephone_number": "214-906-2875",
            "fax_number": "972-771-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSURG SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "MCCARVER",
        "authorized_official_first_name": "MANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-906-2875",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "168736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.