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General NPI Number Information
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NPI Number | 1346237328
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Entity Type | Organization
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Legal Business Name | VICTORIA AMBULATORY SURGERY CENTER, LP
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 6404 NURSERY DR STE 300
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City | VICTORIA
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State | TX
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Zip | 77904-1688
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Country | US
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Telephone | 361-570-8311
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Fax | 361-570-8508
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Provider Business Mailing Address
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Address Line | 6404 NURSERY DR STE 300
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City | VICTORIA
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State | TX
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Zip | 77904-1688
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Country | US
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Telephone | 361-570-8311
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Fax | 361-570-8508
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Authorized Official
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Title or Position | OFFICER / AUTHORIZED OFFICIAL
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Name | NICHOLAS CRAFTS
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Credential |
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Telephone | 832-729-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 008190
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License Number State | TX
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Taxonomy #2
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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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