MEDICARE: NEITH SURGICAL CENTER

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

General Provider Information

NPI Number	:	1063234854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEITH SURGICAL CENTER

Provider Business Mailing Address
First Line	:	2024 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3424
Country	:	US
Telephone Number	:	713-489-1630
Fax Number	:

Authorized Official
Title or Position	:	CMO
Name	:	COURTNEY EL ZOKM
Credential	:	MD
Telephone Number	:	281-703-9524

Provider Enumeration Date	:	10/31/2024
Last Update Date	:	10/31/2024

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