Provider Demographics
NPI:1043697907
Name:SOUTHWEST FREEWAY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SOUTHWEST FREEWAY SURGERY CENTER, LLC
Other - Org Name:SOUTHWEST FREEWAY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-355-8600
Mailing Address - Street 1:4120 SOUTHWEST FWY
Mailing Address - Street 2:200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7339
Mailing Address - Country:US
Mailing Address - Phone:713-355-8614
Mailing Address - Fax:713-355-8615
Practice Address - Street 1:4120 SOUTHWEST FWY
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7339
Practice Address - Country:US
Practice Address - Phone:713-355-8600
Practice Address - Fax:713-355-8615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130234261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical