Provider Demographics
NPI:1518402205
Name:KINGWOOD ASC, LP
Entity Type:Organization
Organization Name:KINGWOOD ASC, LP
Other - Org Name:NORTH HOUSTON CARDIOVASCULAR SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PREIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-644-8900
Mailing Address - Street 1:19502 MCKAY DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:484-924-0053
Practice Address - Street 1:19502 MCKAY DR
Practice Address - Street 2:SUITE 203
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5718
Practice Address - Country:US
Practice Address - Phone:713-812-7586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical