Provider Demographics
NPI:1629319587
Name:LAPGEN SURGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LAPGEN SURGICAL ASSOCIATES, LLC
Other - Org Name:NA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSILIU
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLATOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-279-6465
Mailing Address - Street 1:6633 W AIRPORT BLVD
Mailing Address - Street 2:UNIT 402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5224
Mailing Address - Country:US
Mailing Address - Phone:832-279-6465
Mailing Address - Fax:
Practice Address - Street 1:6633 W AIRPORT BLVD
Practice Address - Street 2:UNIT 402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5224
Practice Address - Country:US
Practice Address - Phone:832-279-6465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208600000X, 363AS0400X
TXSA00449363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty