Provider Demographics
NPI:1144579095
Name:OSD SURGERY CENTER
Entity Type:Organization
Organization Name:OSD SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CNOR, CASC
Authorized Official - Phone:281-404-3280
Mailing Address - Street 1:2121 WILLIAMS TRACE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4526
Mailing Address - Country:US
Mailing Address - Phone:281-404-3280
Mailing Address - Fax:281-404-3281
Practice Address - Street 1:2121 WILLIAMS TRACE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4526
Practice Address - Country:US
Practice Address - Phone:281-404-3280
Practice Address - Fax:281-404-3281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130124261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical