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NPI Code Detail

MEDICARE: GREATER HOUSTON SURGICAL CENTER, INC

MEDICARE: GREATER HOUSTON SURGICAL CENTER, INC
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
1261QA1903XAmbulatory Surgical Clinic/CenterJ2442TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063657021
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER HOUSTON SURGICAL CENTER, INC
Provider Business Mailing Address
First Line : 2105 JACKSON ST
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77003-5839
Country : US
Telephone Number : 281-531-7246
Fax Number : 281-531-4364
Provider Business Practice Location Address
First Line : 2105 JACKSON ST
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77003-5839
Country : US
Telephone Number : 281-531-7246
Fax Number : 281-531-4364
Authorized Official
Title or Position : PRESIDENT
Name : ELIAS BENHAMOU
Credential : MD
Telephone Number : 281-531-7246
Provider Enumeration Date : 12/04/2008
Last Update Date : 12/04/2008

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