Active NPI
Guido Roman Salles Betancourt, LSA
- Surgical Assistant
- Sugar Land, TX
National Provider Identifier
1225588148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 16-499
- Practice address
- 1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478-3540 - Phone
- (832) 655-4141
- Fax
- (713) 457-5188
- NPI assigned
- Oct 4, 2016
- 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 Assistant | 246ZC0007X | 16-499 | TX | Primary |
Addresses
Primary practice location
1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478-3540
Mailing address
1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478-3540
Phone (832) 655-4141
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8LH859 | Other | TX | BCBS - BLUE STAR SURGICAL ASSISTANTS LLC |
| 8KA698 | Other | TX | BCBS - XCITE SURGICAL ASSISTANTS, LLC |
| 8P793 | Other | TX | BCBS - US MSO |
| 8XP793 | Other | TX | BCBS - US MSO |
| SA00644 | Other | TX | TEXAS MEDICAL BOARD |
| 8KA699 | Other | TX | BCBS - UNIVERSAL SURGICAL PARTNERS, INC. |
| 8KC697 | Other | TX | BCBS - UNIVERSAL SURGICAL ASSISTANTS, INC. |
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 |
|---|---|---|---|
| 16-499 | TX | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632787200000",
"number": "1225588148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SUGAR CREEK CENTER BLVD STE 618",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774783540",
"telephone_number": "832-655-4141",
"fax_number": "713-457-5188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SUGAR CREEK CENTER BLVD STE 618",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774783540",
"telephone_number": "832-655-4141",
"fax_number": "713-457-5188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALLES BETANCOURT",
"first_name": "GUIDO",
"middle_name": "ROMAN",
"credential": "LSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-04",
"last_updated": "2021-09-28",
"certification_date": "2021-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "16-499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - BLUE STAR SURGICAL ASSISTANTS LLC",
"identifier": "8LH859",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - XCITE SURGICAL ASSISTANTS, LLC",
"identifier": "8KA698",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - US MSO",
"identifier": "8P793",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - US MSO",
"identifier": "8XP793",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS MEDICAL BOARD",
"identifier": "SA00644",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - UNIVERSAL SURGICAL PARTNERS, INC.",
"identifier": "8KA699",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - UNIVERSAL SURGICAL ASSISTANTS, INC.",
"identifier": "8KC697",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.