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General NPI Number Information
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NPI Number | 1073837290
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Entity Type | Organization
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Legal Business Name | ASP WORTHAM SURGERY CENTER, LLC
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 13114 FM 1960 RD W SUITE 118
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City | HOUSTON
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State | TX
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Zip | 77065-4290
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Country | US
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Telephone | 713-559-9100
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Fax | 713-559-9109
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Provider Business Mailing Address
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Address Line | 13114 FM 1960 RD W SUITE 118
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City | HOUSTON
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State | TX
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Zip | 77065-4290
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Country | US
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Telephone | 713-559-9100
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Fax | 713-559-9109
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Authorized Official
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Title or Position | MANAGING PARTNER/CFO
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Name | CAROLYN BRUCE
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Credential |
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Telephone | 713-554-7500
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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 | 130052
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License Number State | TX
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