Provider Demographics
NPI:1467502849
Name:UNITED SURGEON HEALTH MANAGEMENT CORP
Entity Type:Organization
Organization Name:UNITED SURGEON HEALTH MANAGEMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BYSMARK
Authorized Official - Middle Name:ABRAHAM
Authorized Official - Last Name:ACEBO
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:281-829-0941
Mailing Address - Street 1:PO BOX 431125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77243-1125
Mailing Address - Country:US
Mailing Address - Phone:832-452-6628
Mailing Address - Fax:281-829-9149
Practice Address - Street 1:20023 SKY HOLLOW LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5219
Practice Address - Country:US
Practice Address - Phone:832-452-6628
Practice Address - Fax:281-829-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA0008363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty