Phenomsurgical Assisting

NPI #1376901843 in Fresno, Texas

Provider Information

NPI Number: 1376901843
Entity Type: Organization
Organization Name: Phenomsurgical Assisting
Primary Specialty: Specialist/Technologist, Other - Surgical Assistant
Enumeration Date: Jan 29, 2016
Last Updated: Apr 4, 2016

Practice Location

Address: 4026 E TEAL ESTATES CIR
City: Fresno
State: Texas
ZIP Code: 77545-8851
Phone: (510) 984-8610

Authorized Official

Name: GWENDOLYN CHAMPION, LSA
Title: OWNER
Phone: (510) 984-8610

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist, Other - Surgical Assistant — Surgical Assistant	246ZC0007X	Primary

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