Provider Demographics
NPI:1710438213
Name:TEXAS ALLIANCE SURGICAL CENTER , LLC
Entity Type:Organization
Organization Name:TEXAS ALLIANCE SURGICAL CENTER , LLC
Other - Org Name:ALLIANCE SURGICAL CENTER HUMBLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.D.S./ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-701-9845
Mailing Address - Street 1:3800 N SHEPHERD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6400
Mailing Address - Country:US
Mailing Address - Phone:713-701-9845
Mailing Address - Fax:
Practice Address - Street 1:14315 E. SAM HOUSTON PKWY
Practice Address - Street 2:STE. 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044
Practice Address - Country:US
Practice Address - Phone:713-802-0011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical