MEDICARE: ROC-ASC, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	130073	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130073	OTHER	TX	TEXAS STATE LICENSE

General Provider Information

NPI Number	:	1053407353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROC-ASC, LLP

Provider Business Mailing Address
First Line	:	1200 BINZ ST
Second Line	:	#101
City	:	HOUSTON
State	:	TX
Zip	:	77004-6944
Country	:	US
Telephone Number	:	713-520-1210
Fax Number	:	713-400-8302

Provider Business Practice Location Address
First Line	:	1200 BINZ ST
Second Line	:	#101
City	:	HOUSTON
State	:	TX
Zip	:	77004-6944
Country	:	US
Telephone Number	:	713-520-1210
Fax Number	:	713-400-8302

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MARCOS V MASSON
Credential	:	MD
Telephone Number	:	713-520-1210

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	12/19/2019

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