Provider Demographics
NPI:1407197833
Name:HOUSTON PSC, LP
Entity Type:Organization
Organization Name:HOUSTON PSC, LP
Other - Org Name:PHYSICIANS SURGICENTER OF MEMORIAL VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-763-3859
Mailing Address - Street 1:15305 DALLAS PKWY
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4637
Mailing Address - Country:US
Mailing Address - Phone:214-389-7362
Mailing Address - Fax:214-389-7350
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-799-9990
Practice Address - Fax:713-796-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130144261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical