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General NPI Number Information
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NPI Number | 1811970494
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Entity Type | Organization
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Legal Business Name | FOUNDATION SURGERY AFFILIATES OF S.W. HOUSTON LLC
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 8111 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77074-1705
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Country | US
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Telephone | 713-272-6300
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Fax | 713-272-8532
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Provider Business Mailing Address
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Address Line | 8111 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77074-1705
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Country | US
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Telephone | 713-272-6300
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Fax | 713-272-8532
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ROBERT LERMA
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Credential | MS,MBA,CASC
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Telephone | 713-272-6300
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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 | 007215
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License Number State | TX
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