MEDICARE: NORTH HOUSTON SURGICAL SERVICES

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	363AS0400X	Surgical Physician Assistant	SA00092	TX

General Provider Information

NPI Number	:	1689825382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH HOUSTON SURGICAL SERVICES

Provider Business Mailing Address
First Line	:	5005 HIDALGO ST UNIT 805
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-6425
Country	:	US
Telephone Number	:	713-409-5544
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 HIDALGO ST UNIT 805
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-6425
Country	:	US
Telephone Number	:	713-409-5544
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMAD M SAIJARI
Credential	:	LSA
Telephone Number	:	281-463-6309

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	10/01/2008

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