Provider Demographics
NPI:1952907826
Name:WARREN SURGICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:WARREN SURGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:VELEEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C, CRNFA
Authorized Official - Phone:832-851-8780
Mailing Address - Street 1:10904 LOGGERS LUCK PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1323
Mailing Address - Country:US
Mailing Address - Phone:832-851-8780
Mailing Address - Fax:
Practice Address - Street 1:10904 LOGGERS LUCK PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1323
Practice Address - Country:US
Practice Address - Phone:832-851-8780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32045047928OtherTEXAS SECRETARY OF STATE