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General NPI Number Information
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NPI Number | 1265104822
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Entity Type | Organization
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Legal Business Name | AENT ASC 1
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 10847 KUYKENDAHL RD STE 150
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City | SPRING
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State | TX
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Zip | 77382-2934
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Country | US
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Telephone | 281-875-8428
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Fax | 281-874-0018
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Provider Business Mailing Address
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Address Line | 450 GEARS RD STE 420
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City | HOUSTON
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State | TX
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Zip | 77067-4529
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Country | US
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Telephone | 281-875-8428
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ENRIQUE QUINTERO
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Credential | MD
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Telephone | 281-701-5550
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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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