Provider Demographics
NPI:1689899692
Name:HOUSTON SURGICARE SERVICES P C.
Entity Type:Organization
Organization Name:HOUSTON SURGICARE SERVICES P C.
Other - Org Name:NORTH HOUSTON SURGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SA
Authorized Official - Prefix:DR
Authorized Official - First Name:WAHDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIJARI
Authorized Official - Suffix:
Authorized Official - Credentials:LSA
Authorized Official - Phone:936-271-2438
Mailing Address - Street 1:18 WOODLAKE SQ
Mailing Address - Street 2:208
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3207
Mailing Address - Country:US
Mailing Address - Phone:281-358-8703
Mailing Address - Fax:936-271-2439
Practice Address - Street 1:18 WOODLAKE SQ
Practice Address - Street 2:208
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3207
Practice Address - Country:US
Practice Address - Phone:281-358-8703
Practice Address - Fax:936-271-2439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00096363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00096OtherSURGICAL ASSISTANT