Mid-Cities Surgical First Asst. Inc

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

SA00142 Issued in TX

Legal business name

MID-CITIES SURGICAL FIRST ASST. INC

Practice address

2912 Bourbon St
Fort Worth, TX 76123-1624

Phone

(817) 423-1969

Fax

(817) 361-7954

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Victor Larosa Ruffin Sr., LSA CFA

Title

Chief Executive Officer

Phone

(817) 423-1969

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235335258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 BOURBON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231624",
            "telephone_number": "817-423-1969",
            "fax_number": "817-361-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 BOURBON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231624",
            "telephone_number": "817-423-1969",
            "fax_number": "817-361-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-CITIES SURGICAL FIRST ASST. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUFFIN",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "LAROSA",
        "authorized_official_title_or_position": "CHIEF  EXECUTIVE  OFFICER",
        "authorized_official_telephone_number": "817-423-1969",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LSA CFA"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "SA00142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.