MEDICARE: WINSOME HEALTH SURGICAL MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1184180911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINSOME HEALTH SURGICAL MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	2925 RICHMOND AVE STE 1200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3143
Country	:	US
Telephone Number	:	713-464-7555
Fax Number	:	832-308-1272

Provider Business Practice Location Address
First Line	:	2925 RICHMOND AVE STE 1200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3143
Country	:	US
Telephone Number	:	713-464-7555
Fax Number	:	832-308-1272

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FAHAD A SYED
Credential	:	MD
Telephone Number	:	713-464-7555

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	02/18/2019

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