Healthcare Provider Details

I. General information

NPI: 1457823122
Provider Name (Legal Business Name): COMPLETE SURGERY MESQUITE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 IH 30 STE 300
MESQUITE TX
75150-2601
US

IV. Provider business mailing address

8301 KATY FWY # 401
HOUSTON TX
77024-1944
US

V. Phone/Fax

Practice location:
  • Phone: 214-310-7776
  • Fax:
Mailing address:
  • Phone: 713-461-3399
  • Fax: 713-461-1969

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: AURORA QUIROZ
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 281-899-9380