Provider Demographics
NPI:1548400229
Name:HARRIS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HARRIS COUNTY HOSPITAL DISTRICT
Other - Org Name:AMBULATORY SURGERY CENTER AT LBJ
Other - Org Type:Other Name
Authorized Official - Title/Position:EVP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKITIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-426-0462
Mailing Address - Street 1:4800 FOURNACE PL STE 600W
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2324
Mailing Address - Country:US
Mailing Address - Phone:346-426-0462
Mailing Address - Fax:
Practice Address - Street 1:5550 KELLEY ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-1818
Practice Address - Country:US
Practice Address - Phone:713-566-4768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRIS COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-20
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty