Organization Active NPI

Nomad Surgical Pro PLLC

  • Surgical Physician Assistant
  • Spring, TX
National Provider Identifier
1598290488
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
SA00581 Issued in TX
Legal business name
NOMAD SURGICAL PRO PLLC
Practice address
18703 Duke Lake Dr
Spring, TX 77388-2007
Phone
(281) 653-2924
Fax
(832) 478-9266
NPI assigned
Apr 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Authorized official

Name
Mr. Kheireddine Daoudi, LSANPI 1871978346
Title
President
Phone
(713) 518-2153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X SA00581 TX Primary

Addresses

Primary practice location

18703 Duke Lake Dr
Spring, TX 77388-2007

Mailing address

PO Box 2207
Spring, TX 77383-2207
Phone (281) 653-2924

Other identifiers 1

IdentifierTypeStateIssuer
SA00581OtherTXLICENSED SURGICAL ASSISTANT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1598290488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2207",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773832207",
            "telephone_number": "281-653-2924",
            "fax_number": "832-478-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18703 DUKE LAKE DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773882007",
            "telephone_number": "281-653-2924",
            "fax_number": "832-478-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOMAD SURGICAL PRO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "DAOUDI",
        "authorized_official_first_name": "KHEIREDDINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-518-2153",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED SURGICAL ASSISTANT",
            "identifier": "SA00581",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.