Provider Demographics
NPI:1982369427
Name:MAVEN SURGICAL SERVICES PLLC
Entity type:Organization
Organization Name:MAVEN SURGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:210-724-0415
Mailing Address - Street 1:1735 WITTINGTON PL APT 3104
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-1992
Mailing Address - Country:US
Mailing Address - Phone:210-724-0415
Mailing Address - Fax:
Practice Address - Street 1:1735 WITTINGTON PL APT 3104
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-1992
Practice Address - Country:US
Practice Address - Phone:210-724-0415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty