Provider Demographics
NPI:1922301480
Name:SURGINSITE SOUTHEAST TEXAS
Entity Type:Organization
Organization Name:SURGINSITE SOUTHEAST TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-498-9440
Mailing Address - Street 1:945 MCKINNEY ST
Mailing Address - Street 2:# 256
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-6308
Mailing Address - Country:US
Mailing Address - Phone:586-498-9440
Mailing Address - Fax:586-498-9460
Practice Address - Street 1:945 MCKINNEY ST
Practice Address - Street 2:#256
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-6308
Practice Address - Country:US
Practice Address - Phone:586-498-9440
Practice Address - Fax:586-498-9460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty