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General NPI Number Information
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NPI Number | 1518171891
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Entity Type | Organization
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Legal Business Name | COLORECTAL SURGICAL ASSOCIATES, LTD, L.L.P.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7900 FANNIN ST SUITE 3700
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City | HOUSTON
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State | TX
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Zip | 77054-2934
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Country | US
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Telephone | 713-790-0600
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Fax | 713-790-0616
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Provider Business Mailing Address
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Address Line | 7900 FANNIN ST SUITE 3700
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City | HOUSTON
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State | TX
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Zip | 77054-2934
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Country | US
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Telephone | 713-790-0600
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Fax | 713-790-0616
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BECKEY PRITCHETT
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Credential |
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Telephone | 713-790-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | M4269
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License Number State | TX
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