Pure Surgical Assistant

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

SA00504 Issued in TX

Legal business name

PURE SURGICAL ASSISTANT

Practice address

475 Bendwood Dr
Houston, TX 77024-8813

Phone

(281) 409-3854

Fax

(832) 201-7900

NPI assigned

Aug 21, 2014

Last updated

Sep 10, 2014By 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

Ms. Qijun Song, LSA, SA-CNPI 1982903878

Title

Manager

Phone

(713) 234-0081

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Qijun Song, LSA, SA-C

  • Surgical Assistant
  • Houston, TX
  • NPI 1982903878
  NPD (past) Authorized official

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1902205321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79576",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772799576",
            "telephone_number": "713-234-0081",
            "fax_number": "832-201-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BENDWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770248813",
            "telephone_number": "281-409-3854",
            "fax_number": "832-201-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE SURGICAL ASSISTANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "QIJUN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "713-234-0081",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSA, SA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pure Hope Counseling PLLC
• Pure One Infusion LLC
• Pure Prosthodontics
• Pure Sleep Solutions
• Pure Smiles
• Pure Unity Care Nursing and Rehabilitation
• Puree Inc (Puree Healthcare Services)
• Puremed Essentials LLC
• Purepath RX LLC
• Dalbir S Purewal, M.D.

• Surgical Physician Assistant in Houston, TX
• Providers in Houston, 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 Sep 10, 2014; 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.