MEDICARE: TINY TEXANS SURGERY 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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1275337974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TINY TEXANS SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	1220 CARAWAY CT STE 1050
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-5338
Country	:	US
Telephone Number	:	301-494-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 BINZ ST STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-8107
Country	:	US
Telephone Number	:	346-826-8999
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE ASST.
Name	:	JENNIFER ANTLE
Credential	:
Telephone Number	:	541-219-2904

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	02/17/2026

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