Provider Demographics
NPI:1013085786
Name:ACPS-THE SURGICENTRE
Entity type:Organization
Organization Name:ACPS-THE SURGICENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATRONELLA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:713-799-9999
Mailing Address - Street 1:12727 KIMBERLEY LN
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4047
Mailing Address - Country:US
Mailing Address - Phone:713-354-5128
Mailing Address - Fax:713-722-8998
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:SUITE 306
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-354-5128
Practice Address - Fax:713-722-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007091261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007091OtherAMBULATORY SC LICENSE
1997OtherAAAASF, INC