Provider Demographics
NPI:1477897460
Name:BC SURGERY CENTER OF BELLAIRE LLC
Entity Type:Organization
Organization Name:BC SURGERY CENTER OF BELLAIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GENEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-622-1700
Mailing Address - Street 1:4747 BELLAIRE BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4527
Mailing Address - Country:US
Mailing Address - Phone:713-622-1700
Mailing Address - Fax:713-877-0672
Practice Address - Street 1:4747 BELLAIRE BLVD
Practice Address - Street 2:STE 150
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4527
Practice Address - Country:US
Practice Address - Phone:713-622-1700
Practice Address - Fax:713-877-0672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical