Provider Demographics
NPI:1932492469
Name:NORTHSTAR PROCEDURE SUITES OF HOUSTON,LLC
Entity Type:Organization
Organization Name:NORTHSTAR PROCEDURE SUITES OF HOUSTON,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EFIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-355-8600
Mailing Address - Street 1:4120 SOUTHWEST FWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7340
Mailing Address - Country:US
Mailing Address - Phone:713-355-1500
Mailing Address - Fax:713-622-2314
Practice Address - Street 1:4120 SOUTHWEST FWY STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7340
Practice Address - Country:US
Practice Address - Phone:713-355-1500
Practice Address - Fax:713-622-2314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5807208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty