Provider Demographics
NPI:1629367628
Name:ROYAL SURGICAL GROUP, LLC
Entity Type:Organization
Organization Name:ROYAL SURGICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHENAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-532-7100
Mailing Address - Street 1:PO BOX 79666
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77279-9666
Mailing Address - Country:US
Mailing Address - Phone:832-532-7100
Mailing Address - Fax:832-532-7410
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 510
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:832-532-7100
Practice Address - Fax:832-532-7410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty