Healthcare Provider Details

I. General information

NPI: 1427247675
Provider Name (Legal Business Name): MNS SURGICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 KIRBY DR SUITE 100
HOUSTON TX
77054-2530
US

IV. Provider business mailing address

PO BOX 1759 DEPT 762
HOUSTON TX
77251-1759
US

V. Phone/Fax

Practice location:
  • Phone: 832-201-5157
  • Fax:
Mailing address:
  • Phone: 832-201-5157
  • Fax:

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: JODIE ELLIS
Title or Position: BUSINESS OFFICE SUPERVISOR
Credential:
Phone: 832-201-5157