Provider / Organization | NPI | Date Certified |
---|---|---|
JACOB D SKORUPPA | 1215113022 | 2023-03-12 |
Jacob D Skoruppa is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1215113022. Registration indicates Jacob D Skoruppa is a provider of services with a specialization in Technologists, Technicians & Other Technical Service Providers, Specialist/Technologist, Other (All Other Specialties & Provider Types, ) (Specialist/Technologist, Other Surgical Technologist, Technologists, Technicians & Other Technical Service Providers) (Specialist/Technologist, Other, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
Entity Type | Individual |
Provider Name | Mr. Jacob D Skoruppa LSA |
Practice Office Address | 5929 BRIGHTWOOD DR CORPUS CHRISTI, TX US |
Practice Office Telephone | 3618766689 |
Practice Office Fax | 3613360217 |
Mailing Address | 5929 BRIGHTWOOD DR CORPUS CHRISTI, TX 784143029 US |
Business Telephone | 3618766689 |
Business Fax | 3613360217 |
NPPES NPI REGISTRY [] | https://npiregistry.cms.hhs.gov/registry/provider-view/1215113022 | Direct Cutting edge surgical |
NPPES NPI REGISTRY [] | https://npiregistry.cms.hhs.gov/registry/provider-view/1316361553 | Direct |
Code | Practice | License No State |
---|---|---|
246ZS0410X | Technologists, Technicians & Other Technical Service Providers Specialist/Technologist, Other All Other Specialties & Provider Types Specialist/Technologist, Other Surgical Technologist Technologists, Technicians & Other Technical Service Providers Specialist/Technologist, Other | SA00374
TX |
363AS0400X PRIMARY | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | SA00374
TX |