Provider Demographics
NPI:1225504491
Name:BELEZA SURGERY CENTER LLC
Entity Type:Organization
Organization Name:BELEZA SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRASEKHAR
Authorized Official - Middle Name:BOB
Authorized Official - Last Name:BASU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-799-2278
Mailing Address - Street 1:9899 TOWNE LAKE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6838
Mailing Address - Country:US
Mailing Address - Phone:713-799-2278
Mailing Address - Fax:713-333-2774
Practice Address - Street 1:9899 TOWNE LAKE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6838
Practice Address - Country:US
Practice Address - Phone:713-799-2278
Practice Address - Fax:713-333-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherAMBULTORY SURGERY CENTER