Healthcare Provider Details

I. General information

NPI: 1669396545
Provider Name (Legal Business Name): TOLEDO CHILDREN'S SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 BENORE RD
TOLEDO OH
43612
US

IV. Provider business mailing address

9709 LAKESIDE BLVD, STE STE 420
SPRING TX
77381-1216
US

V. Phone/Fax

Practice location:
  • Phone: 419-776-6374
  • Fax: 419-359-4516
Mailing address:
  • Phone: 713-489-2198
  • Fax: 713-489-2978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEVIN LARSEN
Title or Position: CEO
Credential:
Phone: 208-340-1840