Healthcare Provider Details

I. General information

NPI: 1134419070
Provider Name (Legal Business Name): SUNBELT SURGICAL, LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 CARTWRIGHT RD SUITE 606
MISSOURI CITY TX
77459-3534
US

IV. Provider business mailing address

PO BOX 17923
SUGAR LAND TX
77496-7923
US

V. Phone/Fax

Practice location:
  • Phone: 281-969-8738
  • Fax: 281-969-8882
Mailing address:
  • Phone: 281-969-8738
  • Fax: 281-969-8882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name: THEDA EDWARDS LABOME
Title or Position: BUSINESS OFFICE ADMINISTRATOR
Credential:
Phone: 281-969-8738