Provider Demographics
NPI:1942284682
Name:TEXAS SURGICOM LP
Entity Type:Organization
Organization Name:TEXAS SURGICOM LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-432-1100
Mailing Address - Street 1:6524 SAN FELIPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4048
Practice Address - Country:US
Practice Address - Phone:713-432-1100
Practice Address - Fax:713-432-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451208Medicare ID - Type UnspecifiedGROUP NUMBER