Provider Demographics
NPI:1457674236
Name:CORM SURGICENTER
Entity Type:Organization
Organization Name:CORM SURGICENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-545-1248
Mailing Address - Street 1:1015 W MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-557-3087
Mailing Address - Fax:281-557-5837
Practice Address - Street 1:1015 W MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 2200
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-557-3087
Practice Address - Fax:281-557-5837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical