Michael a. Eller Surgical Assistant Services, LLC

Primary specialty

Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X

License

SA00012 Issued in TX

Legal business name

MICHAEL A. ELLER SURGICAL ASSISTANT SERVICES, LLC

Practice address

1386 Broad Valley CT
Burleson, TX 76028-6502

Phone

(214) 227-2457

Fax

(972) 463-7247

NPI assigned

Nov 2, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Michael A Eller, SA

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": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1922384072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1386 BROAD VALLEY CT",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286502",
            "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": "1386 BROAD VALLEY CT",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760286502",
            "telephone_number": "214-227-2457",
            "fax_number": "972-463-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A. ELLER SURGICAL ASSISTANT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "ELLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-227-2457",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SA"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "TX",
            "license": "SA00012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical-Surgical Clinical Nurse Specialist in Burleson, TX
• Providers in Burleson, TX by specialty
• Medical-Surgical Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.