Provider Demographics
NPI:1508030917
Name:ADVANCED SURGEONS & PHYSICIANS NETWORK, INC.
Entity Type:Organization
Organization Name:ADVANCED SURGEONS & PHYSICIANS NETWORK, INC.
Other - Org Name:SPINE ORTHOPEDIC AND PAIN SURGICAL PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-1152
Mailing Address - Street 1:1911 BAGBY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8594
Mailing Address - Country:US
Mailing Address - Phone:713-383-7147
Mailing Address - Fax:713-383-1302
Practice Address - Street 1:4200 TWELVE OAKS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6812
Practice Address - Country:US
Practice Address - Phone:713-795-4884
Practice Address - Fax:713-383-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204926402Medicaid