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General NPI Number Information
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NPI Number | 1891125621
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Entity Type | Organization
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Legal Business Name | GASTROTEXAS SURGERY LLC
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 24730 KINGSLAND BLVD.
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 561-330-3381
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Fax |
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Provider Business Mailing Address
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Address Line | 777 E ATLANTIC AVENUE, C/O HDA ENTERPRISES, INC. SUITE 222
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City | DELRAY BEACH
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State | FL
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Zip | 33483
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CENTER MANAGER
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Name | MS. CECILIA KRONAWITTER
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Credential |
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Telephone | 561-330-3381
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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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