Provider Demographics
NPI:1326233008
Name:NORTHWEST SURGICAL & CRITICAL CARE ASSOCIATES, PA
Entity Type:Organization
Organization Name:NORTHWEST SURGICAL & CRITICAL CARE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:H
Authorized Official - Last Name:GREGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:936-441-9992
Mailing Address - Street 1:500 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2889
Mailing Address - Country:US
Mailing Address - Phone:936-441-9992
Mailing Address - Fax:
Practice Address - Street 1:500 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2889
Practice Address - Country:US
Practice Address - Phone:936-441-9992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0030EEOtherBLUE CROSS BLUE SHIELD