MEDICARE: TEXAS CRH SURGEONS PA

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	174400000X	Specialist

General Provider Information

NPI Number	:	1477735678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS CRH SURGEONS PA

Provider Business Mailing Address
First Line	:	4040 LAKE WASHINGTON BLVD NE
Second Line	:	SUITE 100
City	:	KIRKLAND
State	:	WA
Zip	:	98033-7874
Country	:	US
Telephone Number	:	425-284-7890
Fax Number	:	425-284-7896

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD STE 402
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2085
Country	:	US
Telephone Number	:	817-467-3000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CONTRACTING
Name	:	SARAH STANDLEY
Credential	:	MBA
Telephone Number	:	425-284-7890

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	04/02/2008

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