Provider Demographics
NPI:1639992894
Name:TEXAS ADVANCED SURGERY CENTER LLC
Entity type:Organization
Organization Name:TEXAS ADVANCED SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PATINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-626-8724
Mailing Address - Street 1:8802 ALATERA GRV
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4899
Mailing Address - Country:US
Mailing Address - Phone:833-626-8724
Mailing Address - Fax:210-783-1910
Practice Address - Street 1:6927 BRISBANE CT STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4922
Practice Address - Country:US
Practice Address - Phone:972-352-3195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical