Provider Demographics
NPI:1780928226
Name:COSMOPOLITAN SURGICAL, PLLC
Entity type:Organization
Organization Name:COSMOPOLITAN SURGICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAJULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-705-0632
Mailing Address - Street 1:2222 GREENHOUSE RD STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7290
Mailing Address - Country:US
Mailing Address - Phone:281-705-0632
Mailing Address - Fax:832-201-0901
Practice Address - Street 1:2222 GREENHOUSE RD STE 900
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7290
Practice Address - Country:US
Practice Address - Phone:281-705-0632
Practice Address - Fax:832-201-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X, 207RG0100X, 261QI0500X, 261QA1903X
TX367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty