Provider Demographics
NPI:1346237328
Name:VICTORIA AMBULATORY SURGERY CENTER, LP
Entity Type:Organization
Organization Name:VICTORIA AMBULATORY SURGERY CENTER, LP
Other - Org Name:THE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAFTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-729-4009
Mailing Address - Street 1:6404 NURSERY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1688
Mailing Address - Country:US
Mailing Address - Phone:361-570-8311
Mailing Address - Fax:361-570-8508
Practice Address - Street 1:6404 NURSERY DR STE 300
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-1688
Practice Address - Country:US
Practice Address - Phone:361-570-8311
Practice Address - Fax:361-570-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008190261Q00000X
261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00243956OtherRAILROAD MEDICARE
TX1777955-01Medicaid
TXP00243956OtherRAILROAD MEDICARE