Provider Demographics
NPI:1255774345
Name:OMNI SURGICAL, LLC
Entity type:Organization
Organization Name:OMNI SURGICAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BISELL
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:512-327-6400
Mailing Address - Street 1:5000 PLAZA ON THE LK
Mailing Address - Street 2:SUITE 305
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1069
Mailing Address - Country:US
Mailing Address - Phone:512-327-6400
Mailing Address - Fax:
Practice Address - Street 1:5000 PLAZA ON THE LK
Practice Address - Street 2:SUITE 305
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-1069
Practice Address - Country:US
Practice Address - Phone:512-327-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies