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General NPI Number Information
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NPI Number | 1346573722
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Entity Type | Organization
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Legal Business Name | WESTGREEN AMBULATORY SURGICAL CENTER, PLLC
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 750 WESTGREEN BLVD
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City | KATY
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State | TX
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Zip | 77450-2799
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Country | US
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Telephone | 281-392-3937
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Fax | 281-392-8671
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Provider Business Mailing Address
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Address Line | 750 WESTGREEN BLVD
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City | KATY
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State | TX
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Zip | 77450-2799
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Country | US
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Telephone | 281-392-3937
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Fax | 281-392-8671
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MR. JIMMY PRICE
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Credential |
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Telephone | 713-275-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 130058
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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 | 130058
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License Number State | TX
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