Provider Demographics
NPI:1659313146
Name:HOUSTON ORTHOPEDIC SURGICAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:HOUSTON ORTHOPEDIC SURGICAL HOSPITAL, LLC
Other - Org Name:FOUNDATION SURGICAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-608-1700
Mailing Address - Street 1:5410 WEST LOOP SOUTH
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401
Mailing Address - Country:US
Mailing Address - Phone:713-314-4500
Mailing Address - Fax:713-314-4550
Practice Address - Street 1:5410 WEST LOOP SOUTH
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-314-4500
Practice Address - Fax:713-314-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008319282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX670012Medicare ID - Type Unspecified
TX008319Medicare UPIN
TX670012Medicare Oscar/Certification