MEDICARE: HOUSTON SURGICAL AND COSMETIC CENTER,LLC

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	261Q00000X	Clinic/Center
2	237600000X	Audiologist-Hearing Aid Fitter

General Provider Information

NPI Number	:	1063705390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON SURGICAL AND COSMETIC CENTER,LLC

Provider Business Mailing Address
First Line	:	9225 BOONE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-2037
Country	:	US
Telephone Number	:	281-933-1700
Fax Number	:	281-933-1705

Provider Business Practice Location Address
First Line	:	9225 BOONE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-2037
Country	:	US
Telephone Number	:	281-933-1700
Fax Number	:	281-933-1705

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CUONG XUAN NGUYEN
Credential	:	D.O.
Telephone Number	:	281-933-1700

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	02/29/2012

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