Healthcare Provider Details

I. General information

NPI: 1659533974
Provider Name (Legal Business Name): SURGICAL GROUP OF THE WOODLANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 PINECROFT DR SUITE 250
THE WOODLANDS TX
77380-3286
US

IV. Provider business mailing address

9200 PINECROFT SUITE 250
THE WOODLANDS TX
77380
US

V. Phone/Fax

Practice location:
  • Phone: 281-419-8400
  • Fax: 281-292-1972
Mailing address:
  • Phone: 281-419-8400
  • Fax: 281-292-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PETAR TURCINOVIC
Title or Position: DIRECTOR
Credential: MD
Phone: 281-419-8400