Promed Surgical Assistants

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

PROMED SURGICAL ASSISTANTS

Practice address

58 Cloverdale CT
Montgomery, TX 77356-8251

Phone

(346) 444-2705

Fax

(832) 218-8987

NPI assigned

Feb 9, 2016

Organization subpart

No

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

Authorized official

Name

Edgardo Isauro Pagoaga, CSA

Title

Owner

Phone

(346) 444-2705

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1134587876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 856",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773560856",
            "telephone_number": "346-444-2705",
            "fax_number": "832-218-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CLOVERDALE CT",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773568251",
            "telephone_number": "346-444-2705",
            "fax_number": "832-218-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED SURGICAL ASSISTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "PAGOAGA",
        "authorized_official_first_name": "EDGARDO",
        "authorized_official_middle_name": "ISAURO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "346-444-2705",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Montgomery, TX
• Providers in Montgomery, 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 Feb 9, 2016; 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.