Sportsman's Paradise Surgical Assistants

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

SPORTSMAN'S PARADISE SURGICAL ASSISTANTS

Practice address

401 Liberty St
Houma, LA 70360-4617

Phone

(713) 589-8606

NPI assigned

Nov 3, 2020

Last updated

Nov 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Henry Haydel II

Title

Owner

Phone

(713) 589-8606

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1780285171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8219",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773878219",
            "telephone_number": "737-999-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LIBERTY ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604617",
            "telephone_number": "713-589-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTSMAN'S PARADISE SURGICAL ASSISTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "HAYDEL",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-589-8606",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Surgical Services, L.L.C.
• Amanda Leonor Soza, PHARM. D
• Spectrum of Possibilities, LLC
• Mark E Spence, CRNA
• Jacqueline B Spencer, BS, MHA
• Krisna Srey, M.D.
• Renee St Germain, NP
• St Luke's Surgery Center, LLC
• St. Anne Rehabilitation Hospital, LLC (Gulf States LTAC of Houma)
• Logan Leblanc St. Cyr, MD

• Surgical Physician Assistant in Houma, LA
• Providers in Houma, LA by specialty
• Surgical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.