Active NPI
Jose P. Morin, CSA
- Surgical Technologist
- Canyon Lake, TX
National Provider Identifier
1154440873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 2940
- Practice address
- 623 Marlys Ave
Canyon Lake, TX 78133 - Phone
- (210) 241-8433
- Fax
- (877) 334-0715
- NPI assigned
- Mar 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 2940 | TX | Primary |
Addresses
Primary practice location
623 Marlys Ave
Canyon Lake, TX 78133
Mailing address
623 Marlys Ave
Canyon Lake, TX 78133
Phone (210) 241-8433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2940 | TX | MD | Surgical Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Medical Services, LLC | Past | Accepting new patients | |
| Hill Country Surgical Assistants | Surgical Technologist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Surgical Technologist
- Canyon Lake, TX
- NPI 1225348048
-
- Specialist
- Canyon Lake, TX
- NPI 1215205521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286841600000",
"number": "1154440873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 MARLYS AVE",
"city": "CANYON LAKE",
"state": "TX",
"postal_code": "78133",
"telephone_number": "210-241-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 MARLYS AVE",
"city": "CANYON LAKE",
"state": "TX",
"postal_code": "78133",
"telephone_number": "210-241-8433",
"fax_number": "877-334-0715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIN",
"first_name": "JOSE",
"middle_name": "P.",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2010-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "TX",
"license": "2940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon Lake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.