Healthcare Provider Details

I. General information

NPI: 1174751812
Provider Name (Legal Business Name): URGENT SURGICAL GROUP OF TEXAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 PINECROFT SUITE 250
WOODLANDS TX
77380
US

IV. Provider business mailing address

9200 PINECROFT SUITE 250
WOODLAND TX
77380
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JASON BALETTE
Title or Position: MANAGING PARTNER
Credential:
Phone: 281-419-8400