Healthcare Provider Details
I. General information
NPI: 1275337974
Provider Name (Legal Business Name): TINY TEXANS SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 BINZ ST STE 200
HOUSTON TX
77004-8107
US
IV. Provider business mailing address
1220 CARAWAY CT STE 1050
UPPER MARLBORO MD
20774-5338
US
V. Phone/Fax
- Phone: 346-826-8999
- Fax:
- Phone: 301-494-3000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFF
WHEELER
Title or Position: CEO
Credential:
Phone: 301-494-3000