MEDICARE: MEMORIAL HERMANN SURGERY CENTER RICHMOND, 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	261QA1903X	Ambulatory Surgical Clinic/Center	130027	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00844266	OTHER	TX	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1366776106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HERMANN SURGERY CENTER RICHMOND, LLC

Provider Business Mailing Address
First Line	:	21155 SOUTHWEST FWY
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-7101
Country	:	US
Telephone Number	:	281-344-5444
Fax Number	:	281-344-5465

Provider Business Practice Location Address
First Line	:	21155 SOUTHWEST FWY
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-7101
Country	:	US
Telephone Number	:	281-344-5444
Fax Number	:	281-344-5465

Authorized Official
Title or Position	:	OFFICER/AUTHORIZED OFFICIAL
Name	:	PETER BLACH
Credential	:
Telephone Number	:	281-344-5444

Provider Enumeration Date	:	09/28/2009
Last Update Date	:	01/22/2026

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