Ricardo Salles Prendes, LSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

SA00645 Issued in TX

Practice address

1 Sugar Creek Center Blvd Ste 618
Sugar Land, TX 77478

Phone

(832) 655-4141

Fax

(713) 457-5188

NPI assigned

Dec 11, 2016

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1649714619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 MORNING COVE LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774498631",
            "telephone_number": "832-952-2030"
        },
        {
            "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": "77478",
            "telephone_number": "832-655-4141",
            "fax_number": "713-457-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLES PRENDES",
        "first_name": "RICARDO",
        "name_prefix": "Mr.",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-11",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00645",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - UNIVERSAL SURGICAL ASSISTANTS",
            "identifier": "8JJ629",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - UNIVERSAL SURGICAL PARTNERS",
            "identifier": "8JY069",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "SA00333",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - BLUE STAR SURGICAL ASSISTANTS LLC",
            "identifier": "8LH898",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  - US MSO",
            "identifier": "8PX800",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - XCITE SURGICAL",
            "identifier": "8JJ618",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.