Provider Demographics
NPI:1942930847
Name:ADVANCED SURGICAL SOLUTIONS OF BELLAIRE, LLC
Entity Type:Organization
Organization Name:ADVANCED SURGICAL SOLUTIONS OF BELLAIRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:979-864-6334
Mailing Address - Street 1:4460 BISSONNET ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3234
Mailing Address - Country:US
Mailing Address - Phone:979-864-6334
Mailing Address - Fax:
Practice Address - Street 1:4460 BISSONNET ST STE 300
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3234
Practice Address - Country:US
Practice Address - Phone:979-864-6334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical