Provider Demographics
NPI:1811220932
Name:ASSOCIATED SURGICAL PROVIDERS, LLC
Entity Type:Organization
Organization Name:ASSOCIATED SURGICAL PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-440-6960
Mailing Address - Street 1:333 N SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-2414
Mailing Address - Country:US
Mailing Address - Phone:281-820-1900
Mailing Address - Fax:281-453-1945
Practice Address - Street 1:333 N SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-2414
Practice Address - Country:US
Practice Address - Phone:281-820-1900
Practice Address - Fax:281-453-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty