=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982417887
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | H-TOWN SURGERY CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2025
-----------------------------------------------------
Last Update Date | 04/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12951 SOUTH FWY STE 200
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77047-1923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-292-0033
-----------------------------------------------------
Fax | 979-292-0488
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 109 PARKING WAY ST
-----------------------------------------------------
City | LAKE JACKSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77566-5228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-292-0033
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. MOIN MEAH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 979-292-0033
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------