MEDICARE: HOUSTON ADVANCED SURGICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363AS0400X	Surgical Physician Assistant
2	261QF0050X	Non-Surgical Family Planning Clinic/Center
3	246RP1900X	Phlebotomy Technician
4	261QG0250X	Genetics Clinic/Center
5	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1689236341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON ADVANCED SURGICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	1110 N LOOP 336 W STE 410-E
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1193
Country	:	US
Telephone Number	:	936-337-3565
Fax Number	:	936-260-0265

Provider Business Practice Location Address
First Line	:	1110 N LOOP 336 W STE 410-E
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77301-1193
Country	:	US
Telephone Number	:	936-337-3565
Fax Number	:	936-260-0265

Authorized Official
Title or Position	:	LAB DIRECTOR
Name	:	DOROTHY M MITCHELL
Credential	:	LSA, CSFA,CST
Telephone Number	:	832-322-6713

Provider Enumeration Date	:	07/02/2019
Last Update Date	:	12/11/2025

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