MEDICARE: HOUSTON SURGERY 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	008005	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00213942	OTHER	TX	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HH028A	OTHER	TX	BCBS
3	7372535	OTHER	TX	AETNA
4	10015837	OTHER	TX	AMERIGROUP

General Provider Information

NPI Number	:	1073554580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON SURGERY CENTER

Provider Business Mailing Address
First Line	:	PO BOX 4346
Second Line	:	DEPT 543
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-521-8772
Fax Number	:	405-286-4997

Provider Business Practice Location Address
First Line	:	6655 TRAVIS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1343
Country	:	US
Telephone Number	:	713-335-1700
Fax Number	:	713-335-1710

Authorized Official
Title or Position	:	ACCOUNT RECEIVABLE SPECIALIST
Name	:	ANGELA DEVOUS
Credential	:
Telephone Number	:	713-521-8772

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/22/2020

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Directions to “HOUSTON SURGERY CENTER ” Practice Location

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