Provider Demographics
NPI:1639195217
Name:CY FAIR SURGERY CENTER
Entity Type:Organization
Organization Name:CY FAIR SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-955-7194
Mailing Address - Street 1:11250 FALLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4229
Mailing Address - Country:US
Mailing Address - Phone:281-955-7194
Mailing Address - Fax:281-890-0895
Practice Address - Street 1:11250 FALLBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4229
Practice Address - Country:US
Practice Address - Phone:281-955-7194
Practice Address - Fax:281-890-0895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007157261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1348OtherBLUECROSS BLUESHIELD
PA323739OtherBLUECROSS BLUESHIELD
TX4442612OtherAETNA
TX=========OtherTAX ID
PA323739OtherBLUECROSS BLUESHIELD