Provider Demographics
NPI:1265104822
Name:AENT ASC 1
Entity type:Organization
Organization Name:AENT ASC 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-701-5550
Mailing Address - Street 1:450 GEARS RD STE 420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-4529
Mailing Address - Country:US
Mailing Address - Phone:281-875-8428
Mailing Address - Fax:
Practice Address - Street 1:10847 KUYKENDAHL RD STE 150
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77382-2934
Practice Address - Country:US
Practice Address - Phone:281-875-8428
Practice Address - Fax:281-874-0018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical