Individual provider Active NPI

Edvige Jane Gusmorino Borden, CST

  • Surgical Assistant
  • Houston, TX
National Provider Identifier
1346508835
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
SA00693 Issued in TX
Practice address
11914 Astoria Blvd
125
Houston, TX 77089-6064
Phone
(281) 482-5300
NPI assigned
May 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X 125878 TX
Surgical Assistant 246ZC0007X SA00693 TX Primary

Addresses

Primary practice location

11914 Astoria Blvd
125
Houston, TX 77089-6064

Mailing address

3006 Avanti CT
Pearland, TX 77584-4917
Phone (281) 413-4978

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL url

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

LicenseStateTypeSpecialty
SA00693TXMDSurgical Assistant
125878TXMDSurgical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1346508835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 AVANTI CT",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844917",
            "telephone_number": "281-413-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11914 ASTORIA BLVD",
            "address_2": "125",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896064",
            "telephone_number": "281-482-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSMORINO BORDEN",
        "first_name": "EDVIGE",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "125878",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "url",
            "affiliation": "N",
            "address_1": "11914 Astoria Blvd",
            "address_2": "125",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770896064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.