Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Homer M Relativo Jr., LSA

Individual provider Surgical Assistant · NPI 1578993499

Homer M Relativo Jr., LSA is a Surgical Assistant in Grand Prairie, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2013
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Practice location Address checks out

2971 Trail Lake Dr
Grand Prairie, TX 75054-5539
Phone: (214) 227-2457
Fax: (214) 764-0880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 11-124 (TX)

Record details

NPI number1578993499
Entity typeIndividual (Type 1)
GenderMale
Credentials LSA
Sole proprietorYes
NPI enumeratedNovember 13, 2013
Last updated in NPPESDecember 20, 2019
Certification dateDecember 20, 2019

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