Preferred Surgical Associates of Texas

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

PREFERRED SURGICAL ASSOCIATES OF TEXAS

Practice address

1208 Paintbrush St
Mesquite, TX 75149-2634

Phone

(214) 227-2457

Fax

(214) 764-0880

NPI assigned

Jan 8, 2018

Last updated

Apr 25, 2019By 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

Mr. Johnny Ray Staton, LSANPI 1922530591

Title

Director

Phone

(214) 980-9437

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Johnny Staton, LSA

  • Surgical Physician Assistant
  • Mesquite, TX
  • NPI 1922530591
  NPD (past) Authorized official

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1942717301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750300938",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 PAINTBRUSH ST",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492634",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2627 Live Oak St Apt 11051",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752045710",
            "country_code": "US",
            "telephone_number": "214-980-9437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREFERRED SURGICAL ASSOCIATES OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "STATON",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-980-9437",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922530591",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Potasznik, M.D.
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• Precious Home Health Care Agency
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• Premier Care Physician
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• Premium Tox Screen LLC (Singular Diagnostics)
• Prescription Medical Equipment & Supplies Inc
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• Surgical Physician Assistant in Mesquite, TX
• Providers in Mesquite, 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 25, 2019; 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.