Provider Demographics
NPI:1114510187
Name:FRONTIER CENTER FOR SURGERY
Entity Type:Organization
Organization Name:FRONTIER CENTER FOR SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF
Authorized Official - Prefix:
Authorized Official - First Name:BACK
Authorized Official - Middle Name:
Authorized Official - Last Name:OFFICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-246-5730
Mailing Address - Street 1:10712 KUYKENDAHL ROAD, SUITE 120
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10712 KUYKENDAHL ROAD, SUITE 120
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381
Practice Address - Country:US
Practice Address - Phone:520-246-5730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical