Provider Demographics
NPI:1497919708
Name:SPRING SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:SPRING SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOPARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-602-8160
Mailing Address - Street 1:25440 INTERSTATE 45
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1343
Mailing Address - Country:US
Mailing Address - Phone:281-602-8160
Mailing Address - Fax:281-466-1052
Practice Address - Street 1:25440 I 45 NORTH
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386
Practice Address - Country:US
Practice Address - Phone:281-602-8160
Practice Address - Fax:281-466-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2481261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2953127-01Medicaid
TXASC416Medicare PIN