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General NPI Number Information
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NPI Number | 1265463640
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Entity Type | Organization
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Legal Business Name | WILLOWBROOK AMBULATORY SURGERY CENTER LP
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13802 CENTERFIELD DRIVE SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77070
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Country | US
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Telephone | 360-402-1433
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Fax | 360-459-2240
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Provider Business Mailing Address
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Address Line | 2318 CARNBEE CT SE
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City | OLYMPIA
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State | WA
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Zip | 98513-3402
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Country | US
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Telephone | 360-402-1433
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Fax | 360-459-2240
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ANDREA MARTELL
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Credential |
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Telephone | 360-402-1433
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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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