Healthcare Provider Details
I. General information
NPI: 1205217593
Provider Name (Legal Business Name): SURGICAL AND CLINICAL ASSOCIATION OF TEXAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2015
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 FANNIN ST SUITE 1200
HOUSTON TX
77054-2934
US
IV. Provider business mailing address
PO BOX 8308
SPRING TX
77387-8308
US
V. Phone/Fax
- Phone: 713-790-0600
- Fax:
- Phone: 800-785-8765
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
HAAS
Title or Position: MANAGING DIRECTOR
Credential: M.D.
Phone: 713-790-0600