Provider Demographics
NPI:1750838801
Name:MEMORIAL HOUSTON SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:MEMORIAL HOUSTON SURGERY CENTER, LLC
Other - Org Name:MEMORIAL HOUSTON SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUTROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-256-8857
Mailing Address - Street 1:9230 KATY FWY
Mailing Address - Street 2:SUITE 601
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7469
Mailing Address - Country:US
Mailing Address - Phone:346-352-1820
Mailing Address - Fax:
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:972-342-4399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical