Provider Demographics
NPI:1861660151
Name:HOWERTON SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:HOWERTON SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAWTHORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-443-9715
Mailing Address - Street 1:2610 S INTERSTATE 35
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5703
Mailing Address - Country:US
Mailing Address - Phone:512-443-9715
Mailing Address - Fax:512-443-9845
Practice Address - Street 1:2610 S INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5703
Practice Address - Country:US
Practice Address - Phone:512-443-9715
Practice Address - Fax:512-443-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130007261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXASC361OtherMEDICARE NUMBER
TX205808301Medicaid