Provider Demographics
NPI:1942255401
Name:BRAZORIA COUNTY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:BRAZORIA COUNTY SURGERY CENTER, LLC
Other - Org Name:BRAZORIA COUNTY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-848-5900
Mailing Address - Street 1:2760 BRAZOS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515
Mailing Address - Country:US
Mailing Address - Phone:979-848-5900
Mailing Address - Fax:979-848-5999
Practice Address - Street 1:2760 BRAZOS PARKWAY
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:979-848-5900
Practice Address - Fax:979-848-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8359261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical