Provider Demographics
NPI:1053879908
Name:TRITIN SURGICAL ASSIST
Entity type:Organization
Organization Name:TRITIN SURGICAL ASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TREY
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-817-8360
Mailing Address - Street 1:9 MEDICAL PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7868
Mailing Address - Country:US
Mailing Address - Phone:214-817-8540
Mailing Address - Fax:888-750-6959
Practice Address - Street 1:809 W HARWOOD RD STE 202
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-6233
Practice Address - Country:US
Practice Address - Phone:817-377-0143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty