MEDICARE: FIRST SURGICAL SOUTHWEST, L.P.

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	261QA1903X	Ambulatory Surgical Clinic/Center	PENDING	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PENDING	OTHER		PENDING

General Provider Information

NPI Number	:	1194900837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST SURGICAL SOUTHWEST, L.P.

Provider Business Mailing Address
First Line	:	6699 CHIMNEY ROCK RD
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77081-5358
Country	:	US
Telephone Number	:	713-665-1111
Fax Number	:	713-665-4146

Provider Business Practice Location Address
First Line	:	6699 CHIMNEY ROCK RD
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77081-5358
Country	:	US
Telephone Number	:	713-665-1111
Fax Number	:	713-665-4146

Authorized Official
Title or Position	:	VICE-PRESIDENT OF CLINICAL SERVICES
Name	:	MS. SYLVIA N. REYES
Credential	:	R.N., C.A.S.C.
Telephone Number	:	713-665-1111

Provider Enumeration Date	:	12/31/2007
Last Update Date	:	12/31/2007

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