OrganizationActive
360 Surgical Assisting of Central Texas,llc
NPI 1790430072 · Surgical Physician Assistant · Austin, TX
Provider details
- NPI number
- 1790430072
- Entity type
- Organization
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Authorized official
- Heriberto Bolanos, Certified Surgical First Assistant
Mailing address
2950 E Old Settlers Blvd Unit 30
Round Rock, TX 78665-2478
Registry dates
- Enumerated
- 2022-02-15
- Last updated
- 2022-02-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.