Provider Demographics
NPI:1932789765
Name:TOMBALL SURGERY
Entity Type:Organization
Organization Name:TOMBALL SURGERY
Other - Org Name:TOMBALL SURGERY ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIET
Authorized Official - Middle Name:
Authorized Official - Last Name:PHUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-677-7769
Mailing Address - Street 1:13519 CYPRESS HEATH CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4481
Mailing Address - Country:US
Mailing Address - Phone:832-677-7769
Mailing Address - Fax:
Practice Address - Street 1:11609 SPRING CYPRESS RD STE C
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8917
Practice Address - Country:US
Practice Address - Phone:281-290-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty