Provider Demographics
NPI:1568423945
Name:NW AMBULATORY SURGERY CENTER LLP
Entity Type:Organization
Organization Name:NW AMBULATORY SURGERY CENTER LLP
Other - Org Name:NW SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-462-3194
Mailing Address - Street 1:4800 FEDERAL PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092
Mailing Address - Country:US
Mailing Address - Phone:713-462-3194
Mailing Address - Fax:713-462-7302
Practice Address - Street 1:4800 FEDERAL PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092
Practice Address - Country:US
Practice Address - Phone:713-462-3194
Practice Address - Fax:713-462-7302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130508OtherLICENSE