Kristine Licensed Surgical Assistant

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

SA00357 Issued in TX

Legal business name

KRISTINE LICENSED SURGICAL ASSISTANT

Practice address

515 Kings Rd
Double Oak, TX 75077-3028

Phone

(214) 227-2457

Fax

(972) 463-7247

NPI assigned

Sep 12, 2012

Organization subpart

No

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

Authorized official

Name

Kristine Krueger

Title

Owner

Phone

(214) 227-2457

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1780934273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 KINGS RD",
            "city": "DOUBLE OAK",
            "state": "TX",
            "postal_code": "750773028",
            "telephone_number": "214-227-2457",
            "fax_number": "972-463-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 KINGS RD",
            "city": "DOUBLE OAK",
            "state": "TX",
            "postal_code": "750773028",
            "telephone_number": "214-227-2457",
            "fax_number": "972-463-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTINE LICENSED SURGICAL ASSISTANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-227-2457"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "TX",
            "license": "SA00357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carey Leann Frazer, FNP-C
• Rebecca Gomez, MD
• Jessica Howell, PA-C
• Kirstin Marie Johnston, PA-C
• Lindsie Kelso, CNP
• Kristine C. Krueger, CST/CSA
• Holli Marie Landin, PA-C
• Lacy E Martinez, APRN
• Taylar Mata, ATC
• Jacquelyn Dee McLain, M.S. CCC-SLP

• All providers in Double Oak, TX
• Registered Nurse First Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.