Provider Demographics
NPI:1316393986
Name:KATY CREEK PROCEDURE SUITE LLC
Entity Type:Organization
Organization Name:KATY CREEK PROCEDURE SUITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:OLSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-292-7411
Mailing Address - Street 1:1544 SAWDUST RD
Mailing Address - Street 2:STE 280
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2929
Mailing Address - Country:US
Mailing Address - Phone:281-292-7411
Mailing Address - Fax:281-292-7481
Practice Address - Street 1:1544 SAWDUST RD
Practice Address - Street 2:STE 280
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2929
Practice Address - Country:US
Practice Address - Phone:281-292-7411
Practice Address - Fax:281-292-7481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty