MEDICARE: PEARLAND SURGICAL SOLUTIONS

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

General Provider Information

NPI Number	:	1538368303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEARLAND SURGICAL SOLUTIONS

Provider Business Mailing Address
First Line	:	2105 JACKSON ST
Second Line	:	#100
City	:	HOUSTON
State	:	TX
Zip	:	77003-5839
Country	:	US
Telephone Number	:	713-691-6000
Fax Number	:	713-691-1273

Provider Business Practice Location Address
First Line	:	2105 JACKSON ST
Second Line	:	#100
City	:	HOUSTON
State	:	TX
Zip	:	77003-5839
Country	:	US
Telephone Number	:	713-691-6000
Fax Number	:	713-691-1273

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	KAREN FEDERER
Credential	:
Telephone Number	:	713-691-6000

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	04/17/2012

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Directions to “PEARLAND SURGICAL SOLUTIONS ” Practice Location

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