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General NPI Number Information
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NPI Number | 1033773023
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Entity Type | Organization
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Legal Business Name | VISION PARK SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 111 VISION PARK BLVD STE 200
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City | SHENANDOAH
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State | TX
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Zip | 77384-3006
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Country | US
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Telephone | 281-845-3378
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Fax | 936-267-3166
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Provider Business Mailing Address
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Address Line | 111 VISION PARK BLVD STE 200
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City | SHENANDOAH
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State | TX
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Zip | 77384-3006
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Country | US
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Telephone | 281-845-3378
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Fax | 936-267-3166
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERWIN LO
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Credential | MD
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Telephone | 281-845-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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